Cornwall 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

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 newly registered service. This key question has been rated 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 service was in breach of legal regulation in relation to oversight of the service.

This service scored 54 (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.

Staff could not recall what the provider’s vision or mission statement was. They were issued with a staff handbook, but this had no reference of a shared direction.

Some members of the staff team were related. There was no policy for this scenario. This meant the manager and staff did not have appropriate guidance to follow to mitigate inherent risks. The manager put this in place immediately.

People and their relatives were complimentary of their kind and caring staff. Their comments included, “without hesitation would recommend the service.” Staff told us they felt listened to.

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

One member of staff had not received, induction, regular supervision or appraisal from the registered manager, this meant opportunities to discuss their development, review performance and provide support were missed. Staff could not recall if lessons were learnt or shared amongst staff if anyone spoke up. People told us, “I have confidence in the staff and management” and “I would tell my friends about Cornwall Homecare and say that I have no issues.”

Some staff spoke positively of the registered manager and the support and guidance they provided. They told us, “If there was an issue you can approach [registered manager] with it no matter what it was.” Another said, “Registered manager would do the first care call and then go back to see what can be done to improve and what further training might be needed.”

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

There was a survey in place so staff could raise anonymous concerns. Some people knew how to contact the registered manager or office if they had concerns and one said, “It was a positive experience”. Staff told us, “Registered manager very much encourages us if anything could be handled different.” However, staff did not always understand when to report concerns and how to escalate if required for example daily notes indicated one person’s legs were hot to touch. This had not been raised as a concern to the registered manager for follow up and further investigation.

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 well and supported equally by the management team. Requests for reasonable adjustments to working patterns were looked on favourably with staff having flexible shifts to cover school runs and medical appointments.

All staff completed training on Equality, Diversion and Inclusion and Human Rights, fostering a respectful and inclusive workplace culture.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The service’s governance systems were ineffective and had failed to ensure compliance with the requirements of regulations. Processes had not ensured medicines were administered safely, care records were not always accurate or up to date, staff were not always recruited safely, and call visits were not monitored to ensure staff were staying their full duration.

Prior to the assessment, issues were identified with the effectiveness of the service’s governance arrangements by the local authority quality assurance team. The registered manager engaged positively, and improvements were made however, they had not been maintained. The lack of effective quality assurance systems meant the provider was in breach of the regulation relating to governance.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

The registered manager did not always engage effectively with health care professionals. One professional told us a person's ability to leave their home had been restricted and this was carried out with the persons advocate but without commissioned oversight and agreement.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people.

The provider did not ensure learning was identified and acted upon following incidents, accidents or complaints. Although these had been recorded, opportunities for learning and improvement had been missed. The registered manager had not documented their reviews of these incidents. Where information on the management of risk had been informally shared with staff, people’s care plans had not been consistently updated with guidance for staff.