Homelium West Sussex

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 service. This key question has been rated requires improvement. The service was in breach of legal regulation in relation to good governance. Governance and quality assurance systems were not effective and had not identified or addressed all the shortfalls found during the assessment. This included oversight of care plans and risk assessments, safeguarding and incident records, and compliance with the provider’s conditions of registration.

This service scored 57 (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 an understanding of the challenges and needs of people and their communities. The provider promoted person-centred care, dignity, choice, independence and respect. Staff understood these values and described a supportive and inclusive culture. One staff member said, “They have created a good culture here.” Most people and relatives described the service as well organised and said they were happy with the care and support provided.

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, or they did not always do so with integrity, openness and honesty. There was no registered manager in post at the time of the assessment. A care manager led the service day to day and was supported by the nominated individual and the provider’s wider management team. An application for the care manager to register with CQC had been submitted. People and staff spoke positively about the care manager and described them as approachable and contactable, although they were not always available. One staff member said, “I feel like sometimes when the managers are busy and we need questions answered they are not always around, but our questions do get answered eventually.” However, leadership oversight had not identified and addressed all the shortfalls found during the assessment, including those relating to safeguarding and incident records, risk management and quality assurance. This meant leaders did not always have effective oversight of the quality and safety of people’s care.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff said they felt comfortable raising concerns and challenging poor practice. Supervision and appraisal records showed staff were given opportunities to discuss concerns, suggest improvements and comment on the support they received from managers. One staff member said, “I feel comfortable, I would always raise a concern.” However, another staff member said, “I have repeatedly raised concerns about rota planning and insufficient travel time but feel I have not been listened to and do not feel enough action had been taken.” Supervision records confirmed staff had previously raised similar concerns about travel time. This showed that although staff felt able to speak up, the provider had not always demonstrated that their concerns were heard or acted on.

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 had an equality and diversity policy which promoted fair treatment and a workplace free from discrimination, bullying and harassment. Staff spoke positively about the diversity of the workforce. One staff member said, “We are all different ages, and we all get on very well no matter our age or experience.” They added, “The service was recruiting staff of different nationalities. I feel they are very inclusive here.”

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 provider’s governance and quality assurance systems were not effective. Audits and management checks had not identified or addressed all significant shortfalls. These included concerns with care plans, risk assessments, safeguarding and incident records and oversight of compliance with the provider’s registration conditions. Safeguarding and incident records did not consistently demonstrate the actions taken, outcomes, escalation decisions or learning. This meant leaders did not have accurate and complete information to identify and manage risks, monitor the quality and safety of the service or drive improvement. Following our feedback, the provider submitted an action plan setting out additional audits, trackers and management reviews. However, these actions were at an early stage and the provider had not demonstrated that the improvements were fully implemented, effective or embedded.

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 with local authority commissioners and health professionals to coordinate people’s care and respond to concerns. Local authority feedback showed the provider investigated and responded when concerns about missed or late visits were raised. Health professionals said the provider shared information promptly when people’s needs or risks changed, attended joint visits and acted on their recommendations. This supported coordinated care and enabled improvements to be made when concerns were identified.

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. They did not always actively contribute to safe, effective practice and research. The provider had started a branch improvement plan covering areas including compliance, care records, feedback, complaints and staff support. However, this work was recent, and the provider had not demonstrated that the actions had been completed, evaluated or had resulted in sustained improvement. Learning from accidents, incidents, complaints and safeguarding concerns was not consistently recorded, analysed or shared with staff. There was limited evidence of analysis to identify themes, recurring risks or opportunities for improvement. Although information was sometimes shared through meetings and informal communication, there was no consistent process for ensuring learning resulted in changes to practice. Following our feedback, the provider submitted an action plan setting out additional arrangements for recording, analysing and sharing learning. However, these changes were at an early stage, and their effectiveness had not been demonstrated.