Custom Home Care

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 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 requires improvement. At this assessment the rating has remained 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 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. The provider had an employee handbook in place for members of staff but there was no information about the organisation’s vision or values. We looked on the provider’s website and there was no information there about the organisations’ vision or values which could be accessed by people using the service or people interested in using the service in the future. It was unclear how members of staff were supported to uphold the values of the organisation.

Leaders had the skills and knowledge to lead effectively; however, they did not always understand the context in which the provider delivered care, treatment and support. Leaders had not identified need for notify and apply to CQC to add the appropriate service user bands so care and support could be provided to people with a learning disability or autistic people in line with the ‘Right support, right care, right culture’ guidance. People and relatives we spoke with, told us the management team were helpful and friendly. They knew who the registered manager was and told us they were helpful, proactive and responsive. One relative said, “The registered manager knows everything. They are very responsive. I have been kept informed.” Another relative said, “[The registered manager] seems to know what they are doing. It has met our requirements.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. There was a whistle-blowing policy in place for all members of staff. A member of staff told us, “I feel valued and listened 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. Members of staff told us they felt valued by the management team and the provider. One member of staff said, “I feel valued and listened to by the registered manager and the provider.”

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did, however, act on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. We saw evidence of audits, reviews and checks on the quality of care delivered to people, however, we did not see evidence of performance and quality monitoring reports or discussions between the registered manager and the provider where quality was discussed. We identified areas for improvement in people’s care plans in relation to information about recording and reviewing assessments of people’s mental capacity to make informed decisions and their preferred means of communication and engagement. The provider and the registered manager had not applied to CQC to include the appropriate service user bands to provide care and support to people with a learning disability and autistic people. There was limited understanding of CQC’s guidance ‘Right support, right care, right culture’.

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 had an information sharing agreement in place with all key health and social care organisations in the local area. We saw evidence of attendance at local meetings where updates about people’s care were discussed, and actions agreed to improve outcomes for them.

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. There was limited evidence about a joined-up approach to learning in the organisation. Whilst accidents and incidents were reviewed and analysed, there was an insufficient amount of evidence to demonstrate organisational learning and continuous service improvement.