Thames Homecare Services Greenwich Branch

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 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.

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 had a shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding the challenges and needs of people and their communities. However, inconsistent responses to complaints raised and ongoing issues with timekeeping meant we could not be assured the shared direction and culture was being always upheld.

Most people told us they received kind and considerate care in line with their needs and wishes. Positive comments included, “I would highly recommend this service to others” and “I would recommend this agency 200%, they are amazing.” However, less positive feedback included, “The carers are great, I wouldn’t fault them, but the office never notify me if I have a change of carer or a late call” and “I have called the office numerous times to talk about visits taking place when they are meant to.”

Notwithstanding these concerns staff spoke positively about the shared culture of the organisation. There were regular meetings scheduled to ensure staff had the opportunity to discuss the values of the service and make suggestions for improvement.

The provider understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. There were systems in place to monitor people’s experience of care. People told us staff carried out regular spot checks and monitoring calls to gather feedback about the service. Comments included, “I get a survey every so often and they phone me up to check we are happy, I would recommend the company, [family member] is happy with the service” and “The office send a lady out to carry out spot checks, sometimes she arrives when the carers are there to check them too.”

Staff told us managers were experienced and provided support and guidance when needed. A staff member said, “If I have any problems, I call the office and speak to the supervisor. They are very helpful and supportive.”

The provider fostered a positive culture where staff felt they could speak-up and their voices would be heard. Systems were in place to facilitate speaking up including whistleblowing policies and safe spaces to raise concerns such as supervisions and team meetings. Comments from staff included, “If I had any worries about anything I would raise it with my manager. We can raise it in the staff meetings or speak to the supervisor” and “I feel I can raise issues or problems I have. Managers take things seriously.”

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 told us, “Our workforce reflects the local community and the diversity of people who use our service.”

Staff were treated equally and fairly at work. The registered manager told us, “Religious inclusion has been supported through leave for faith observance and recognition of key festivals such as Christmas, Ramadan, and Easter. This helps staff feel respected and strengthens a sense of belonging.”

Staff received training to develop their knowledge and understanding of equality, inclusion and fairness in the workplace. Staff had equal opportunities to learn and progress in their roles if they wished to do so. A staff member told us, “I really love this job. No two days are the same. I am constantly learning and developing.”

The provider did not have effective systems of good governance to assess, monitor and improve the quality of service being provided. They did not act on the best available information about risk, performance and outcomes.

There was a system of audits and checks in place, but these had not been effective as they had failed to identify the issues we found with care plans, risk management plans, medicine records, consent records. These shortfalls exposed people to the risk of poor care from staff who did not have sufficient information about how to mitigate risks to people’s health and wellbeing. The provider’s systems had also not been effective in identifying shortfalls with their recruitment processes.

We raised all these concerns with the provider during the assessment, and they have submitted an action plan detailing how they will improve their governance systems and processes.

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 provider worked in partnership with health and social care professionals when required. The provider had also implemented different approaches to strengthen partnership working and engagement. They told us, “We hosted a coffee morning at a local community centre, making it accessible for people and their families to meet the registered manager and coordinators, share feedback, and develop trust.”

There was effective communication with external partners when people’s needs changed. The provider also supported people to communicate with housing and utility service providers when people could not do this themselves.

The provider’s systems had not always been used effectively to drive learning and improvements. Prior to our assessment we were informed there had been a rising number of concerns raised about timekeeping. Our analysis of care records and call times showed this was a persistent concern that had not been resolved so we could not be assured there was an effective culture of continuous learning improvement and innovation. When we raised our concerns about the ongoing audits of the ECM system the provider told us they had plans to improve the auditing process. However, as the new process had not been fully instigated, we could not be assured of its effectiveness.