Angels Care At Home Ltd

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 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. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The values, mission and vision were documented in the services statement of purpose and in the handbook given to people when they started using the service. Leaders had focussed on recruiting experienced health and social care staff. They had plans in place for the direction of the service in the future which included ensuring they had the “right staff in the right roles being efficient and effective.”

Staff members told us the values of the service were, “Treat people like family, give utmost respect and care,” and “To uphold the company policies, not to bring the company into disrepute and promoting dignity and respect for people.”

Staff and people also felt the new registered manager had brought some stability to the service due to their knowledge and skills set.

Not all leaders demonstrated a full understanding of the context in which care, treatment, and support were delivered. We identified gaps in leaders’ knowledge relating to the assessment of capacity and completion of Mental Capacity Act (MCA) documentation. Leaders acknowledged this and advised they would undertake further training to strengthen their understanding. We also found gaps in governance systems that had not been identified through leaders’ own oversight processes.

However, we observed improved oversight of the service since the appointment of the new registered manager. People and staff told us they were able to contact the registered manager when needed and felt the service was now better managed. Feedback reflected that leaders were approachable and supportive. Comments included, “Nothing but supportive and helpful,” and “I have met the new registered manager. They seem really nice and are taking the company in the right direction. They seem like a good asset to the company and always at the end of the phone and responsive.”

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

Staff told us they felt able to speak up about any concerns they had. Comments included, “We are encouraged to speak up during meetings and supervisions, anytime we want.”

Staff were aware of the whistleblowing policies and how they were able to speak up internally and externally. They said they would also encourage people they supported to raise any complaints internally or externally.

Leaders told us they encouraged staff to discuss any concerns with them through an open door policy, during supervisions and meetings.

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 provided positive comments about how they were treated at the service. Comments included, “There is a culture of respect, irrespective of background. I feel recognised, it makes me feel active to work with them. No bullying or discrimination, not at all.”

Leaders told us, “Staff have access to training in equality, diversity and inclusion (EDI) and there is a diverse team of staff working in the service. They reinforced EDI messages during supervisions and team meetings, and care plans had people’s information about their culture and preferences.”

Staff had received training in EDI and demonstrated a very good awareness of how they should treat people they were supporting. For example, 1 staff member told us, “I always look for discrimination everywhere I go because of the people I work with. Some people can be so cruel and judgmental and degrading to people with different needs. Some people enjoy making others feel ‘less than’ but people should be who they are, whoever they are and wherever they are from.”

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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.

Existing audits had not identified several of the concerns found during this assessment. These included gaps and inconsistencies in care records, conflicting information within care plans, and a lack of decision-specific MCA assessments within care planning and risk assessments. Issues with early or late visits had still not been effectively monitored or addressed through governance systems. This meant governance processes still need improvement and were not yet fully embedded into practice.

Although recruitment practices had improved overall since the last inspection, we identified some minor concerns, including employment gaps not being formally documented. This demonstrated that governance processes were not yet consistently applied across all areas.

However, there was some evidence of progress. Regular audits were being completed, and these had identified certain issues which had been acted upon. Policies that were previously incomplete with relevant information had since been reviewed and updated to include the required information.

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.

Partners now told us they were able to contact the service and received a timely response. They felt the newly appointed registered manager had strengthened communication with partners. We saw the provider had been working collaboratively with partners to make the improvements needed. Partners noted there had been some improvements made but the service needed time to embed practices.

We saw evidence of people’s needs in the community being assessed and there was evidence of staff supporting people with accessing the community.

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.

Some shortfalls identified during the previous inspection had still not yet been fully embedded. This was in relation to governance and quality assurance systems and the ongoing issues with scheduled visit times.

However, we observed some improvements. Daily notes were now more detailed, and there was evidence of the registered manager working closely with staff to improve the quality of recording. At the previous assessment, live-in care records were maintained within people’s homes. These had now been incorporated into the electronic care management system, providing better oversight of people’s care and outcomes.

The provider had also introduced new systems to strengthen payroll and human resources processes, although these were not yet fully embedded at the time of the assessment. In addition, the provider had reviewed the efficiency of staff rostering and had taken steps to recruit a care coordinator to improve the management and scheduling of visits. Staff told us the provider was open to their suggestions and gave examples of how the provider had taken on board their ideas. For example, 1 staff member told us about how they suggested a visit route could be changed to be more effective for the service user and staff.