Tamworth Home Care Limited

On this page

• 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. At our last inspection we rated this key question inadequate.

At this inspection the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider was previously in breach of legal regulation in relation to the governance of the service. Improvements were found at this inspection and the provider was no longer in breach of this regulation.

This service scored 61 (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 did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

While improvements had been made further work was needed to ensure people and relatives feedback was listened to and any actions taken were reviewed to ensure they led to improvements in the quality of the service people received.

Since the last inspection the management team have worked hard to improve the culture of the service and most staff spoke positively about the changes made, telling us things felt more settled. Other staff felt communication needed to improve. Comments included, “Communication is what I feel is lacking. This is an on-going problem.”

The provider’s systems and process had also been strengthened, and managerial oversight had improved. However, further time was needed to ensure these processes are fully embedded and sustained. During this inspection, we gave feedback to the management team about some issues we had found, and they acted quickly to address these.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

Since our last inspection there have been further changes to the management team, with the new manager only recently taking up the post. This meant some required improvements had not been fully implemented, sustained or embedded.

Some people and relatives did not know who the new manager of the service was and had not informed of the recent management changes. Numerous people told us they were frustrated by this. Furthermore, people were frustrated messages they had left with office staff had not been passed to care staff.

While systems were in place to guide staff on the expectations of their role, responsibilities and tasks, some staff told us they needed clearer direction following the changes in the management team.

We acknowledge the management team had started to address this and had taken the opportunity to review the responsibilities allocated to senior staff when the new manager took up their post. One staff member said, “We have a meeting with the new manager this week. This is the second since she started. I think it’s to give us more updates which is good to keep us in the picture."

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

Staff felt confident to raise any issues or concerns with the management team. One staff member told us, “I would report any concerns immediately, so the manager could take the necessary actions to keep the person safe.”

The provider held regular team meetings, where staff had the opportunity to raise concerns and offer suggestions. The manager understood the need to be open and honest when things went wrong in line with the responsibilities under the duty of candour.

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.

All staff had the opportunity to provide feedback through questionnaires. Senior staff told us they felt more included in decisions about the service since the new manager had started.

All staff had received equality and diversity training. The provider’s policies and procedures promoted equality and diversity, and a diverse staff team has been recruited to support people using the service.

The provider demonstrated a commitment to promoting equality and inclusion in the workforce by supporting staff with flexible working requests to help them balance their home and work commitments.

At our last inspection the provider had failed to operate robust governance systems. Improvements were found at this inspection and the service was no longer in breach of this regulation.

Managerial oversight and governance of the service had improved. A range of systems and processes were in place to monitor the quality and safety of the service. However, further improvements to ensure for example all concerns raised by people and relatives were fully explored and addressed. During our inspection we were informed, staff had left a care call without ensuring the person could reach their mobile phone, which was their only means of calling for help in case of an emergency. When we discussed this with the management team, they were able to confirm they had spoken with the staff member, however no information was available to show what action had been taken to reduce the risk of reoccurrence.

Some staff spoke positively about the changes made following our last inspection. One staff member said, “Things seem to be running more smoothly now. There is more communication.”

The nominated individual demonstrated an understanding of the regulations and their responsibilities in relation to these. For example, they had informed us about important events within the service.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

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 advocated for people with other professionals and were clearly confident when seeking advice on health and wellbeing for those people they supported.

The management team continued to work closely with the local authority quality teams to drive improvements to the quality of the service provided.

The provider did not always focus on continuous learning and improvement across the service. While some improvements were evident following our last inspection, further improvement was needed to ensure all staff received the appropriate level of training and were confident in their roles.

At this inspection people, relatives and staff shared similar concerns to those when we last inspected Tamworth Home Care regarding the quality of staff training and some staffs’ understanding of people’s needs due partly to not knowing the person well and a lack of awareness of certain health conditions.

The management team were responsive to our feedback and told us they would review the training provided and arrange some additional training for staff on health conditions such as dementia to increase their awareness and skills.

Improvements had been made to the providers quality monitoring systems, including care records and the values and culture of the staff team. This demonstrated some lessons had been learnt.