Dolphin Healthcare Services

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 good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 71 (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 provider had a clear statement of purpose and vision and strategy for the service which the leaders were aware of. Values of the service were important to the leaders we spoke with, and they told us they were incorporated into everyday processes.

The provider was clear about the standards they expected, providing support and guidance when staff had failed to meet the standard. The provider had a vision in place to support their business to grow. There was evidence of regular supervisions available, and appraisals for staff that demonstrated discussions of the values. Audits and spot checks were actioned regularly with care led competency checks. Staff said, “Every month we have spot checks, and if we need extra support we can ask.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience, and credibility to lead effectively. They did so with integrity, openness, and honesty.

Staff gave positive feedback about the management team and the culture of the service. Staff could talk to the office staff and the management team at any point and felt involved and included in the day to day running of the service and any changes that occurred. Staff felt supported and were confident about the management’s responsiveness. Staff had team meetings, as well as 1-2-1 support and supervisions, which provided opportunities for discussing any issues with the service and how to make improvements.Relatives were also positive about the management and told us they were confident should they need to raise any concerns action would be taken.

A staff member said, “I will describe the management team as a very compassionate one because I feel listened to, anytime I raise a concern the management stepped in to support me financially and constantly checked on me to know if it had been resolved.”

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

There was a policy in place to support staff to raise any concerns. Staff were comfortable raising any issues with the registered manager and the management team. Staff understood other avenues available to them to share concerns about the service if they were worried and demonstrated a knowledge of the provider’s policy. The registered manager had regular discussions with staff and felt confident staff would raise concerns if required.

A staff member said, “During supervisions, being asked if there's anything I am concerned about, if I'm struggling or there are any challenges, and then am advised to always speak about my concern at any time to the management.”

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 and procedure in place. The policy worked to ensure the provider embraced the principles of the Equality Act 2010 and ensure everyone was treated fairly taking account of any protected characteristics. Staff told us the registered manager ensured they were well supported.

A staff member said, “My induction began with Policies Values, Confidentiality, Equality and diversity, respecting dignity and promoting independence.”

During the inspection, we identified concerns regarding the provider’s oversight of electronic call monitoring (ECM) systems. There was evidence of multiple staff logging into dual locations simultaneously, and one staff member had worked consecutively for 61 days, this raised serious questions about staff wellbeing, safe working practices, and the accuracy of care delivery records. The registered manager reviewed the ECM data during the inspection and acknowledged that although one staff member had worked for 61 consecutive days, these were not full shifts. On several occasions, the work involved covering short calls, some lasting only an hour.

Additionally, the planning of care calls lacked sufficient travel time between visits, which could compromise both staff welfare and the continuity of care for service users. These issues were not detected by the provider’s internal audit processes, indicating that governance systems were not robust enough to identify and address operational risks.

The provider initiated a responsive investigation following the inspection. However, as these anomalies were identified during the inspection, we could not be assured that existing governance arrangements were always effective in identifying areas for improvement. There was insufficient scrutiny of ECM data, and the lack of internal escalation mechanisms meant that risks to people and staff went unaddressed until highlighted by inspectors.

Whilst these findings demonstrated a need for stronger systems of accountability, improved data oversight, and more effective use of performance information to drive quality and safety improvements; the provider worked with us during the inspection to begin making these improvements.

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 manager told us they worked with social care, advocacy, and health care professionals to improve the service provided to people and to ensure a consistent service was received. Where people had contacts with health professionals, the recommendations for care and the outcomes were included in care plans to ensure people’s care needs were being met consistently.

A relative said, “I feel like the carers are part of our family. They accompany us when we go out for lunch and stay with us when we go on short breaks. Without their support, my loved one’s quality of life would be very different.”

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome, and quality of life for people. They actively contributed to safe, effective practice and research.

The provider, who was also the registered manager, had recently worked with three local authorities to ensure action plans were in place following concerns raised about the quality of the service. The manager worked with the local authorities to implement an action plan and make improvements to the service.

The service supported a small number of people with a learning disability and autism. The provider was aware of specific guidance including Right support, right care, right culture and staff had received specific training so they could support people.

A staff member said, “My induction begins with discussions surrounding safeguarding and its procedures. Communication was discussed. Speaking clearly and respectfully to service user was emphasised. Listening and showing empathy and the need for proper documentation.”