Chenai Holistic Home Care Agency 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 changed to inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was previously in breach of the legal regulation in relation to governance. Improvements were not found at this assessment, and the service remained in breach of this regulation.

This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Feedback from people, relatives and staff showed the provider had not succeeded in ensuring they were part of, and aware of, the provider’s aim for a shared vision, strategy and culture. We found a lack of transparency, equity, equality and human rights, diversity and inclusion, and engagement.

People and relatives consistently told us the service they received did not meet their expectations. The feedback for the management of the service was mainly negative. A person told us, “It is poorly managed. They don’t call me back and have only been out once to assess my needs." A relative said, “it’s an awful company, completely awful.”

We received mixed feedback from staff about the culture. For example, a staff member told us, “The management team is supportive, approachable, and responsive. They keep us well-informed and provide guidance when needed. The service is well organized, and there is a clear focus on delivering high-quality care.” However, another staff member said, “It is the management that are the problem – how they treat us and talk to us. The work is ok. They just say: if you say no or can’t, then there is no annual leave for us.”

Not all leaders understood the context in which care, treatment and support should be delivered and how to demonstrate this. They did not always embody the culture and values of their workforce and organisation. Feedback from people included that at times communication could be difficult and leaders were not very approachable. Concerns identified in the assessment demonstrated leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

Staff experience working at the service was very different. We received anonymous feedback from staff raising concerns about the approach of leaders and how the service was being run. One staff member told us, “The lack of professionalism and disregard for client care is truly troubling, and I believe it is important that this issue is addressed appropriately” But another staff member told us “Our manager is very understandable and encouraging. I think their dedication and determination ensures our company runs smooth, they are also very approachable.” The registered manager was unable to tell us why there were such different views from staff. They felt leaders were approachable and that they had different initiatives to reward staff. They said the service was run “like a family.”

People did not always feel they could speak up and that their voice would be heard.

During and following the site visit element of the assessment we continued to receive feedback from staff who told us they were unable to speak up or have their concerns listened to. They were concerned it would impact negatively on their job for example cancel their sponsorship or refuse their annual leave. They told us they were often asked to cover at short notice, which they felt unable to refuse as there was an expectation they would cover. This meant they felt unable to make plans.

A staff member told us, “When concerns or issues are raised, management is slow to respond, and sometimes, no action is taken at all.”

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

We had mixed views from staff regarding how they were treated. Some staff were positive about their job role whilst others told us they were not happy and looking for other work. A staff member told us, “Overall, working with Chenai Holistic Homecare Agency has been a positive experience. The focus on quality care and the supportive environment makes it a good place to work, and I feel proud to be part of the team.” Another staff member said, “Concerns raised by staff are often ignored or dismissed, leading to frustration and low morale. At present, our company does not appear to be managed at all, and serious improvements are needed.”

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.

The governance and quality assurance had failed to ensure people received a consistently good service. Oversight and checking people received their care as it was planned was not robust. Oversight of care plans, risk assessments, spot checks and staff roles/competency have not identified short falls. There have been missed opportunities to identify where quality and safety were being compromised and responded to without delay. This includes lack of up to date and accurate record keeping, identifying changes to risk and service user needs, and identifying, escalating and reporting of safeguards.

People and relatives using the service raised many concerns about the governance of the service and the treatment of staff. A relative told us, “The carers are overworked, and management doesn’t seem to care. There’s not much support from above, the carers just get on with it." Another relative said, “There doesn’t seem to be any oversight on what they are doing. Nobody checks if they are doing their jobs properly."

The provider did not understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not share information and learning with partners or collaborate for improvement.

Concerns had been identified by partner agencies and these concerns were still being looked into. We were concerned about differing information being communicated to us and partner agencies by the provider.

The records we viewed and feedback we received did not demonstrate that the service worked in collaboration with people and staff when they raised concerns or shortfalls.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not actively contribute to safe, effective practice and research.

The provider did not demonstrate they had a good understanding of their registration requirements in relation to escalating concerns or clarity of what level of care they could provide.

They failed to ensure people, relatives and staff were involved in developing and improving the service. Whilst records we viewed indicated involvement; feedback we received did not support this.