Exceptional Care At Home (Barnet)

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service. This key question has been rated good.This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff described a supportive working culture and worked collaboratively to provide safe care. A care worker told us, “Team members are cooperative.”

The registered manager promoted an open and transparent culture and used feedback, audits and monitoring to improve practice. For example, when concerns were identified through complaints or audits, the registered manager took action, provided feedback to staff and improved practice, which helped ensure issues did not recur and care was delivered consistently.

The registered manager engaged with people effectively, and people’s views were reflected in how care was provided. Leaders used monitoring systems to maintain reliable care delivery, ensuring visits were completed as planned and people received consistent support. These actions demonstrated how leadership influenced practice and contributed to positive outcomes for people, including safe, person‑centred and reliable care.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders were visible and supportive, and staff told us they felt able to seek advice when needed. Staff described a positive working environment where managers were responsive and actively involved in supporting care delivery and resolving issues.

Leaders demonstrated an understanding of people’s needs and the wider system, working with external partners and responding to changes in people’s care requirements.

Complaints and concerns were managed transparently, with feedback used to improve practice. A care worker told us, “If any problem happens, everyone cares about it and solves it immediately.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us they could raise concerns with the registered manager and care coordinators, who were accessible and responsive to issues. Staff described clear escalation processes and were confident to report concerns about people’s safety or changes in need, with evidence that these were acted on in a timely way.

The registered manager used supervision sessions and team meetings to reinforce a culture of honesty. A care worker told us that if they had a concern, “I would call my line manager and discuss.”

The provider had a whistleblowing policy in place, which staff could access electronically. While staff did not explicitly refer to the policy, their responses demonstrated an understanding of how to raise concerns and confidence that these would be taken seriously and acted upon.

People and their relatives also knew how to raise concerns and reported that the provider responded appropriately, demonstrating that feedback was listened to and acted on.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had policies in place to support equality, diversity and inclusion. The provider’s statement of purpose confirmed a commitment to equality, human rights and inclusion, supported by compliance with relevant legislation and delivery of culturally sensitive and linguistically appropriate care. During our inspection, we observed staff being treated with respect. Staff told us they felt supported by the registered manager and care coordinators and were treated fairly, which contributed to an inclusive culture.

Leaders supported equality and inclusion in practice by ensuring staff had equal access to training, supervision and guidance, including training in equality, diversity and inclusion, which enabled them to carry out their roles consistently and effectively.

Staff delivered care in a way that respected people’s diverse needs and used interpreting services where required. Leaders used these arrangements to ensure people received fair and inclusive care and that staff experienced a positive and respectful working environment.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The registered manager monitored the quality of care and maintained oversight of care delivery and staff practice. Leaders reviewed information from monitoring, feedback and complaints, identified concerns, and took action to improve practice. For example, when a concern was raised about tasks not being completed, leaders investigated the issue, provided feedback to staff and achieved improvement, with no recurrence.

Staff understood governance arrangements and followed clear escalation and communication pathways, which ensured care was delivered consistently and in a coordinated way. These arrangements supported the stability of the service and people received reliable care that met their needs. One relative told us, “Any problems and the carers phone me straight away. They called me when they phoned for an ambulance,” demonstrating timely escalation and communication.

Governance processes were well structured and effective; however, leaders did not always use audit findings to demonstrate detailed analysis or sustained challenge. This limited the extent to which governance systems could fully identify emerging or low-level risks and test the effectiveness of systems over time.

Despite this, leaders acted promptly on identified issues and maintained oversight of care delivery. Monitoring, feedback and outcomes for people showed that care remained safe, consistent and responsive. This demonstrated that governance systems were effective overall, although opportunities remained to strengthen analysis and further enhance assurance.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Staff worked in partnership with external organisations, including local authorities, healthcare professionals and community services, to ensure people’s needs were met and risks were managed appropriately. For example, staff worked with hospital discharge teams to coordinate care packages, which ensured people received support without delay and reduced the risk of gaps in care when returning home.

Staff also worked with healthcare professionals, such as occupational therapists and district nurses, to respond to changes in people’s needs. This included arranging reassessments, additional support and equipment, which helped people remain safe and independent in their homes.

The provider shared information appropriately with relevant professionals to support continuity of care and decision‑making. Joint working supported consistent care delivery, as staff followed agreed plans and worked in a coordinated way with other services.

The provider also worked with family members and representatives to support collaborative decision‑making, which helped ensure people’s preferences were understood and responded to promptly. These arrangements improved continuity of care and contributed to safer, more responsive support for people.

The provider focused on continuous learning and improvement across the organisation. They used feedback, incidents and audit findings to improve practice and supported staff to learn and develop.

Leaders investigated concerns and used learning to improve care, including addressing issues raised through complaints and monitoring. Staff received feedback through supervision and meetings, which supported reflection and improvement in practice.

Governance and monitoring arrangements supported ongoing review of care, and actions were taken where issues were identified to improve outcomes. While learning and improvement were well established, there was limited evidence of innovation or wider contribution to research.