Support at Home

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• 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.

The service was in breach of legal regulation in relation to Good Governance at the service.

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. They did not always understand the challenges and the needs of people and their communities.

We were not always assured that the principles of Right Support, Right Care, Right Culture were fully embedded within the service. Whilst staff demonstrated a caring and respectful approach in their interactions and supported the person’s independence within a supported living model, this was not consistently reflected within care planning and risk assessments. Care records did not always clearly demonstrate how the person’s preferences, needs, and associated risks were understood and translated into person-centred support. The registered manager acknowledged they were not fully familiar with the Right Support, Right Care, Right Culture guidance but were receptive to feedback and committed to implementing improvements.

The provider did not constantly ensure people were supported in line recognised guidance and systems had not identified the short falls.

The registered manager had not implemented Right Support, Right Care, Right Culture guidance and had not ensured risks were consistently assessed, planned for and mitigated.

Staff however spoke positively about the support they received from the management team. The registered manager showed a willingness to learn and improve and was open to feedback during the assessment. They recognised areas for development and were committed to strengthening oversight and monitoring arrangements.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff felt able to speak up and raise concerns within the service. They told us they felt supported by the management team and were confident they could share any worries or issues. This demonstrated an open and transparent culture where staff felt listened to. The registered manager told us, “We have an open-door policy,” which supported what we were told.

There was a whistleblowing policy in place, and staff were aware of this and the procedures they needed to follow to raise concerns.

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 spoke positively about working within the team and told us they felt valued and supported by the management team. This helped create a culture where staff felt able to contribute and be themselves.

Processes were in place to support equality and diversity, including training and policies that guided staff on inclusive practice. Staff demonstrated an understanding of respecting people’s individual differences, including the person’s religious needs, and applied this in their approach to care.

The provider did not always have clear responsibilities, roles, systems of accountability and good governance. They did not always act on the best information about risk, performance and outcomes.

We were not always assured that governance systems were effective in identifying and addressing areas of concern. Although processes such as audits and monitoring systems were in place, these had not consistently identified issues relating to care planning, risk management, and record keeping. This meant there was limited assurance that the service was effectively monitoring the quality and safety of care or driving sustained improvements.

In addition, care records were not always accurate, complete, or reflective of the person’s current needs, which further impacted oversight and the ability to ensure consistent care delivery.

The registered manager confirmed actions would be taken to strengthen oversight and monitoring arrangements. We will check these changes have been effective at our next assessment.

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 service worked with external agencies to support people’s needs where required. The registered manager told us, “There is support from external agencies, such as social and mental health teams.” The service also had access to a range of professionals, including mental health services, pharmacists, and GPs. Records confirmed the provider worked in partnership with other professionals when needed to support the person’s health and wellbeing.

The person was supported to maintain links with their community, where appropriate, which demonstrated the service promoted independence and community engagement.

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.

We were not always assured that learning and improvement were consistently embedded within the service. Whilst systems such as care plan audits and monitoring processes were in place, these had not always been effective in identifying the gaps we found relating to the person’s care planning, risk management, and record keeping. This meant opportunities for learning and improvement were not always recognised or acted upon.