Home Instead - Bromley, Chislehurst & Orpington

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 outstanding. At this assessment, the rating has remained outstanding.This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 96 (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 clear shared vision, strategy and culture built on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an understanding of the challenges and needs of people and their communities.

Leaders supported a culture of openness, inclusion and respect, embedding the provider’s values through recruitment, supervision and performance management. Staff were recruited for their values and behaviours, and leaders addressed concerns promptly when practice fell below expectations.

Leaders actively sought and acted on feedback from staff, people and relatives, creating a culture where concerns could be raised openly and addressed quickly. People and relatives consistently praised the team, commenting, “We can’t speak highly enough of them” and “A lovely group of people they have almost become part of the family.”

Staff understood and applied the vision and values day to day. Leaders promoted an open culture aligned with Duty of Candour, and staff, people and relatives told us they could approach the registered manager with any concern and that concerns were addressed promptly.

This culture was reflected in day-to-day practice. Staff demonstrated the provider’s values through compassionate support, positive relationships and a commitment to achieving outcomes that mattered to people. As a result, people experienced continuity, trust and high-quality care.

The strong culture translated directly into consistent, compassionate care experiences. People experienced continuity, trusted relationships and high-quality support from a workforce that was engaged, motivated and committed to delivering outstanding care.

The provider had capable, compassionate and 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, and did so with integrity, openness and honesty.

Leaders actively role-modelled inclusive practice. When the service welcomed its first overseas-recruited member of staff, leaders recognised that moving to a new country, workplace and community at once was a significant transition. They set out a tailored induction, paired the person with a named mentor, and provided practical and cultural support to help them settle] As a result, the staff settled quickly, felt part of the team, and went on to support the people. Leaders used what they learned to shape how they welcomed and supported staff who joined the service from overseas afterwards.

Staff spoke positively about leaders. One said, “The managers are very supportive. They are always available to help with any concerns and give me the support I need.” Another described leadership by example and a culture in which “there is no sense of status we are all valued for the role we have and the work we do.”

Leaders kept staff informed through electronic systems, a staff newsletter and regular supervision, ran an annual feedback survey with strong participation, and maintained a clear focus on training and development.

The capability of senior leadership had been recognised externally through a sustained record of awards and finalist positions over four years. Between them, the registered manager and managing director received eleven awards, finalist positions and commendations, including national-level recognition for care delivery and for contributions to adult social care and dementia care offering independent validation of the leadership and culture observed.

Leaders’ inclusive practice gave internationally recruited staff a genuine sense of belonging, building the stable, motivated workforce that underpinned the continuity of care people valued.

The provider was exceptional at fostering a positive culture where people knew they could speak up and their voice would be heard.

Staff at all levels had routes to raise concerns, and the provider actively invited challenge rather than waiting for it. The registered manager sought feedback on their own performance from the whole staff team and acted on what came back. A monthly reflection process gave office staff a structured way to raise issues and allowed the provider to monitor themes over time alongside its open-door arrangements.

This was demonstrated when care staff supporting one person raised a concern in a team meeting that the tasks expected went beyond the support set out in the person's care plan, and that this placed them under pressure to deliver the person's primary care needs within scheduled visits. The registered manager reviewed the expectations and the care package openly with the person, their relative and the care team, and the arrangement was changed.

Staff told us they were confident raising concerns and that action would follow. Annual anonymous staff survey results showed almost all staff considered it safe to speak up and challenge how things were done. Concerns surfaced early and were resolved before they affected people's care.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.

Staff recruited from overseas were supported in practical and personal ways, including help to settle, familiarisation with daily living, buddying arrangements and support to access entitlements, so they could work confidently and remain with the service.The provider acted decisively where staff experienced discrimination, making clear that abuse of staff would not be tolerated and supporting the staff member concerned. Champions for wellbeing, menopause and inclusion gave staff routes to raise issues affecting them.

The provider adjusted duties and rotas so staff with health conditions could continue working and access training and progression on the same basis as others. Staff from all backgrounds described a culture in which they were respected and could speak openly, and staff survey results reflected this. Staff experienced an inclusive workplace in which difference was actively valued rather than simply accommodated.

The provider had clear responsibilities, roles, systems of accountability and good governance. Leaders used these to manage and deliver high-quality, sustainable care, treatment and support. They acted on the best available information about risk, performance and outcomes, and shared it securely with others when appropriate.

Leaders operated effective governance that gave clear oversight of quality, safety and performance. They reviewed incidents, identified trends, and put learning into practice by updating care plans, supporting staff and involving healthcare professionals. They embedded safeguarding and workforce governance within wider quality assurance. Although few safeguarding referrals had been raised in 12 months, the registered manager recognised this could indicate under-reporting and took proactive steps to assure themselves staff understood their responsibilities and felt confident to raise concerns.

Leaders strengthened oversight through several layers of independent scrutiny: quarterly owner’s audits of records, staff files and operations; a thorough audit by the provider’s national office; and an external consultant’s mock inspection. Leaders used the resulting reports to identify themes, prepare action plans and complete improvements, and these checks also developed the wider team.

The registered manager carried out regular care spot checks, daily review of care records, and audits of incidents, medicines and changing needs, while the management team tracked patterns across the service and acted on them. The registered manager told us, “I can see first-hand if a person’s condition has deteriorated, or if there is anything we need to pick up medicines or moving and handling equipment that needs changing. It’s an extra check.”

Using feedback from staff, people and relatives, leaders introduced an easy-read complaints procedure, involved families more fully in reviews, and strengthened recognition, supervision and career development to support retention and develop future leaders.

Leaders maintained a business continuity plan identifying who needed uninterrupted essential care so they could prioritise safely during disruption and closely monitored staffing against contracted hours.

People benefited from a service that continuously improved and adapted in response to feedback and learning. Risks were identified early, quality remained consistently high and people experienced safe, responsive and well-managed care.

The provider understood their duty to collaborate and work in partnership, so that services worked seamlessly for people. Leaders shared information and learning with partners and worked together to improve people’s care.

Staff worked proactively with external professionals, including speech and language therapists, physiotherapists and other health specialists, so that people received the right support at the right time. Through these relationships, staff helped people maintain healthier lifestyles and access healthcare, dental care, physiotherapy and exercise. The provider took part in community events to raise awareness of dementia and to highlight the support, services and products available locally and nationally, and the registered manager delivered presentations on caring for people living with dementia.

The provider maintained effective working relationships with external healthcare services, which supported integrated care that met people’s needs and helped them live as independently as possible. Staff worked closely with GPs, district nurses, therapists and hospital teams to share information, make timely referrals and support safe transitions when people moved between services. Leaders built strong links within the local community to support people’s inclusion and wellbeing. They engaged with cultural and faith organisations to help people receive culturally appropriate care, and signposted people to wider community services, social opportunities and health support networks.

The provider focused strongly on continuous learning, innovation and improvement across the organisation and the wider local system. Leaders encouraged creative ways of improving equality of experience, outcomes and quality of life for people, and contributed to safe, effective practice.

Lleaders shared they critically reviewed their own performance data. In the most recent annual survey, staff scored overall engagement at 92%, but rated work-life balance lower than before. Leaders said they treated this dip as an early warning rather than an acceptable result and acted on it by introducing monthly reflection sheets that asked staff to reflect honestly on their wellbeing and what further support they needed. The owner and registered manager reviewed these and fed actions into weekly development meetings. This is how leaders first identified the staffing concern described elsewhere in this report early, and before it affected people’s care.

Leaders applied the same rigour to incidents, audits, feedback and complaints, identifying themes and acting to prevent recurrence. In response, they introduced falls-prevention checklists, strengthened auditing, improved monitoring of people at high risk, and used one-page profiles to match staff to people more effectively. Staff feedback directly shaped the service, prompting easy-read information and fuller family involvement in reviews.

By questioning even strong results, leaders caught a risk to staff wellbeing before it could affect people, protecting the continuity of care that depends on a stable, supported workforce.