Dignity Direct Homecare Ltd - Sheffield

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.

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.

The service was in breach of legal regulation in relation to good governance.

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. They did not always understand the challenges and the needs of people and their communities. Staff received regular supervisions and appraisals, and we received positive feedback from staff regarding the culture and morale amongst the team. The service had clear visions and values in place. However, due to concerns we found during this assessment and feedback we received from people, we could not be assured the staff and management team worked towards a shared direction for the service.

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. There was a clear management structure in place. However, the management team did not always effectively monitor the quality and safety of the service. Whilst we received positive feedback from staff regarding the management team, some people and relatives told us the service was not well led and they often struggled to get in touch with the management team. A staff member said, “The manager operates an open-door policy, listens to concerns, and treats staff fairly.” A person told us, ““It needs a better system to respond to queries. I don’t know what they do. But what I request doesn’t happen. I’ve mentioned it to them (managers) a few times.” And a relative told us, “I think if they change the manager that then they will have a stronger organisation. The manager needs organisation and communication (skills). I feel the manager didn’t listen to us.”

People did not always feel they could speak up and that their voice would be heard. Staff told us they felt able to whistle-blow on poor practice. Staff had been involved in feedback surveys and these showed overall staff satisfaction and feeling supported. However, we received mixed feedback from people and relatives about feeling 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. Equal opportunities policies and procedures were in place. No staff told us they had faced any form of discrimination. The service benefited from a diverse workforce, and some staff were sponsored from overseas. All staff were supported with their professional development. A staff member said, “The manager is very open, fair and approachable, staff can raise any concerns.”

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. Governance systems had not always identified or actioned concerns we found. Audits showed a high level of compliance; however, this did not reflect what we found. Audits in relation to care records, medicines management and monitoring accidents, incidents and safeguarding concerns had not always recognised or actioned improvements required.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. Partnership working was not always effective in supporting safe and consistent care. Care records contained discrepancies, omissions and conflicting information, which meant information shared with external professionals and partner agencies may not always have been accurate or up to date. The service worked with a range of healthcare professionals and the local authority; however, concerns identified during the assessment indicated opportunities had been missed to ensure information was effectively communicated, reviewed and acted upon to support people's wellbeing and safety.

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. Whilst we found some improvements had been made at this assessment some concerns remained since our last assessments. Quality improvement plans had not been effective in ensuring the service operated effectively on a day-to-day basis. Whilst systems had been implemented, these required further embedding and overarching monitoring to ensure they were effective in improving the safety and quality of care for people. The local authority was working closely with the service to support in making and sustaining improvements.