Dimensions South West Counties Domiciliary Care Office

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 assessment we rated this key question Good. At this assessment the rating has remained 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 68 (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.

The provider had a clear strategy based on person centred support to ensure people were at the centre of the service. This was seen in action in several homes. However, in 1 of the 7 homes visited people were not always being supported in a person centred way. The provider was working with the local authority to ensure the home was brought in line with other services. In another home a relative shared they felt the service was not supporting the person in an equitable way due to shared support that they felt was not always balanced equally between people.

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.

Staff told us that most managers were supportive and were available if they needed to talk to them. Staff had regular supervisions and team meetings.

People did not always feel they could speak up and that their voice would be heard. The provider had whistleblowing procedures. However, some staff told us they had expressed concerns about 1 home and the support provided to people. The manager had not addressed the issues they had raised. However other staff told us they could talk to managers and felt their feedback was acted upon.

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. Staff told us they were treated fairly and as individuals by the provider. The provider engaged with staff within team meetings and supervisions.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. One home was experiencing several issues which compromised peoples’ safety, specifically in relation to medicine management and in their quality of life, particularly in relation to right care right support right culture expectations. This was in part due to a lack of oversight from the provider. This put people at risk of poor support in a number of areas of their lives. The service supported people with more complex needs and therefore there is a concern that the people were not always able to speak out and challenge their support.

The local authority had raised concerns with the provider who had acknowledged the issues and were taking steps to address them. The provider had better oversight in the rest of the homes they were providing support to.

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. Managers we spoke to told us they worked with a range of other professionals such as physiotherapy, speech and language and occupational therapists. Families also confirmed they had experienced good partnership working between the provider and other agencies.

People were supported to go into their local communities to access activities of their choice.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

The provider was delivering care based on ‘right support, right care, right culture’, and in a person centred way.

Staff received a variety of training, including core training modules and extra training that was bespoke to peoples’ support needs. They did this in partnership with other agencies such as SALT, physiotherapy and behaviour nurses as needed.

We saw 1 person with complex support needs have their support plans changed and adjusted to ensure they were being supported in the least restrictive way. This included how staff engaged with them when they were feeling overwhelmed with techniques

One service was very dependent on agency staff. This meant they were not always supporting people in a person centred way. We raised this with the provider, and they addressed this immediately by introducing the retention of regular agency and by training them to use their systems. They also completed some core training to ensure they were working to the same level as permanent staff.