Care at Home Services (South East) Limited – Eastbourne, Hailsham and the Weald

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

The manager 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. The manager was experienced but newly appointed in their role at this service. However, they had quickly established themselves and told us about their vision and strategy for the future of the service. At the heart of this was putting people first and maintaining and improving safety for people in their homes. They championed the development of their staff team and were aware of the importance of striking a positive work life balance for staff to ensure a happy and hardworking team. Business continuity and strategy plans were in place and were reviewed annually. Clear direction for staff was recorded in the event of an incident that affected the whole service for example, severe adverse weather. The most vulnerable people supported by the service, those living alone and those with specific daily support needs, were prioritised. The manager kept themselves up to date with developments in adult social care.

The manager 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. The manager had an established team of staff that were split according to geographic area. Although there were no team leaders, each area was supported with regular contact from the office and manager and a Field Care Supervisor. The Field Care Supervisor carried out a thorough program of visits to staff when on calls, to check medicine and other competencies. These visits were recorded and were overseen by the manager. There was an on-call rota in place and staff could call for support and advice at any time. Staff acknowledged that the manager was new but they were positive saying they were available and approachable and provided the support they needed to enable them to provide safe support to people. A staff member said, “In the field they are accessible and supportive. They are just a call away.”

The manager fostered a positive culture where staff felt they could speak up and their voice would be heard. Staff had several ways they could raise issues, concerns or provide feedback about good or poor practice. Team meetings were held regularly in each geographical area and minutes from these meetings showed that staff were encouraged to speak up if they needed to. Staff had regular supervision meetings which were documented and again provided opportunities to speak up. A member of staff told us, “Can raise any issue. Depending on what it is, can raise at team meetings or sometime privately (at supervision meetings or ad hoc meetings). Team meetings are every 3 months.” Although staff were still getting to know the new manager they told us they and the wider management team were approachable and supportive and listened and acted on issues raised.

The manager 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 manager valued and celebrated diversity and promoted the celebration of festivals, religious high days and other important cultural dates. The manager said, “We celebrate everyone. We adjusted some care calls recently for staff fasting during Eid. Several staff observe Sunday as a Holy day and we work around this for them, without missing any actual care calls.” Staff told us that they felt comfortable working for the service which was free from any form of discrimination or unfair or unsupportive behaviour of practice.

The manager had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. Despite the manager having only recently taken up the role at the service, there was an ongoing and embedded processes for auditing all areas of the service. These processes created overviews which enabled the manager to have immediate oversight of any themes or trends identified. For example, a recent audit of staffing revealed that some supervision meetings and some observations were overdue. This was then identified by the manager who was able to take steps to improve the situation. Care plans and risk assessments were reviewed 6 monthly or more frequently following an incident, accident of other significant events involving the person. Some discrepancies had been identified between medicine records and care plans which again had quickly been addressed by the manager with the support from their wider team. The manager and their team made telephone calls to people, seeking direct feedback about the service they were receiving. This was an ongoing process and if there were any concerns these were discussed and addressed.

The manager 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 about positive working relationships that had developed with other health and social care professionals. This led directly to people receiving the right specialist support when needed. Communication pathways between the service and other professionals ran smoothly and if urgent appointments were necessary with for example, an Occupation Therapist, then the right people were contacted in a timely way. The manager was aware of their responsibilities under the duty of candour, a legally binding process that made sure certain events that affected the service were reported to the local authority and the CQC.

The manager 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 manager acknowledged the importance of continuous improvement and learning from both positive and negative events that occurred. Incidents were subject to full debriefing sessions with staff involved and any learning was cascaded to all staff. Where necessary action was taken to support staff by providing additional training and supervision. Systems were in place to capture learning and best practice. For example, the service used a complex falls assessment program that considered all aspects that may contribute to people who were at risk of falling, experiencing a fall. By placing some control measures around identified risk, the number of falls had decreased.