Right at Home Bexley & Dartford

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.

This is the first assessment for this newly registered 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 71 (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 management team and provider were passionate about the service and wanted to ensure people had good quality care and improved outcomes. The provider’s statement of purpose stated, ‘Our aim is to provide high quality care in a way which supports the independence of individuals and enables them to remain in their own homes for as long as possible.’ We found that the service was achieving their aims.

The staff gave positive feedback about the culture of the service. Staff reported a positive open culture where they felt empowered to raise any concerns or make suggestions. Comments included, “Their (provider) heart is in the right place, they make the effort to make sure clients’ needs are met” and “It’s a good workplace with strong managerial support. Concerns are addressed promptly.”

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. The management team knew people well and were passionate about making sure people received good quality care. Staff understood their responsibilities to meet regulatory requirements. The registered manager (who became registered during the assessment) was supported by the nominated individual for the provider.

Services providing health and social care to people are required to inform the CQC of important events that happen in the service. This is so we can check that appropriate action has been taken. We were assured that incidents had been appropriately reported.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Complaints processes were available. Relatives confirmed the management team were responsive and accessible. Comments included, “Things do improve. Incontinence care has improved after discussions” and “I can speak to the manager, they are responsive.”

Staff confirmed they were invited to meetings and encouraged to contribute. Staff felt listened to. A staff member said, “We have good support. Managers are approachable, arrange meetings, and guide on providing the best care.” Staff meeting minutes evidenced that these took place regularly. Staff told us they were encouraged to voice their ideas for improvements and any concerns. Staff knew how to raise concerns with the provider or outside organisations if they needed to.

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 felt they were treated well and supported equally by management. The provider had processes in place to encourage an inclusive culture, and support was in place for staff. For example, the management team had created a wellbeing checklist for staff which they used with staff after a staff member has supported a person with end-of-life care. Any issues could be discussed openly at staff meetings or during supervision. Staff told us they would not hesitate to speak to the management team if they needed to.

The provider had clear responsibilities, roles, systems of accountability or good governance. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. The provider had systems in place to check the quality of the service. Audits had been carried out. There were monthly audits of infection control, health and safety, care plans, medicines, communication, staffing and recruitment. The audits were not always robust, some of the issues we found in this assessment had not always been captured in the audits. Where the management team had identified shortfalls and areas for improvement in the service, these had been added to an action plan and worked through by the management team.

The service was supported by a quality assurance manager, there was support for the service from the quality assurance manager in the form of visits, audits and advice and guidance. There was peer support available for the management team from regular meetings with other managers across the Right at Home franchise. The registered manager told us they really valued this support.

People's personal records were stored securely including on computers and applications on devices, these were protected by passwords, so that only staff who had been authorised to access the information could do so. Staff said the management team were supportive and approachable. A staff member told us, “My manager is approachable and supportive.”

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. The management team were keen to build links and had liaised with the local authority and local integrated care board. There were also strong links through community partners such as the local hospice, local tea dance and dementia café. There were plans in progress to develop a Parkinson’s café to support people living with Parkinson’s disease and their relatives. The registered manager was involved in forums and events to keep abreast of local and national developments in health and social care.

The registered manager and nominated individual for the provider told us they had reviewed the feedback we gave them as part of the onsite and offsite assessment process and valued this. They were using the feedback to make improvements to the service and to put systems in place to embed the changes. Areas discussed at the assessment site visit were added to the action plan for the organisation in a timely manner and the registered manager updated CQC on the progress of these actions.