In Home Care Chichester

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 changed to 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.

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. People were treated with dignity and respect, and people were placed at the heart of the service. The core values of the organisation were embedded into the culture of the service, through team meetings, staff supervisions and observed practice. Staff told us the leadership of the service embedded a culture of providing people with good, person-centred care in the safety of their own homes and this was what they strived to deliver daily.

Leaders did not consistently demonstrate a strong and visible presence within the service or a comprehensive understanding of relevant models of care. At the time of inspection, the service was supporting 2 people with a learning disability. The registered manager was not familiar with the Care Quality Commission’s Right support, right care, right culture guidance. As a result, they were unable to clearly demonstrate how this guidance was embedded within practice to promote person-centred care, independence, and uphold the human rights of autistic people and people with a learning disability.

The registered manager had appropriate skills and experience and acted with integrity, openness, and honesty. They told us they were present in the Chichester office twice a week due to wider responsibilities across other services. Day-to-day management responsibilities were delegated to the office manager. We received positive feedback about the day-to-day management of the service.

The provider did not always foster an open and transparent culture where staff felt confident to speak up and have their voices heard. Processes were in place to enable concerns to be raised openly and anonymously. However, some staff did not feel able to speak up because they were fearful of how this might impact their employment status. To protect staff confidentiality, we provided generalized feedback to the provider and sign posted staff to appropriate organisations for advice.

Policies and procedures were in place to enable staff and visitors to provide feedback about the service. Staff told us team meetings and supervision provided opportunities to discuss concerns, challenges, and ideas for improvement.

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. The provider employed staff from diverse cultures and ethnic backgrounds. We received mixed feedback from staff about their employment experiences. Some staff did not feel the provider treated them with respect, equality, or equity and some did not feel the provider acted with integrity. Staff shared examples of their experiences with us. To protect staff confidentiality, we provided generalized feedback to the provider and sign posted staff to appropriate organisations for advice.

We balanced this with positive feedback received from staff, who said they were treated fairly including upholding religious beliefs and describing the provider as good and making them feel valued and included.

The provider did not always operate fully effective systems of good governance. Oversight of governance and quality monitoring processes was not consistently robust. The registered manager had additional responsibilities across services. We were therefore not assured they were able to maintain consistent and effective oversight of governance at the service. As a result, monitoring systems were not always as effective as they could have been in identifying and addressing areas for improvement in a timely way. Processes in place to monitor risk, performance and outcomes were not always implemented effectively. Some care records and monitoring documents lacked accurate information and detail. Quality monitoring processes had failed to identify these issues prior to the inspection.

The provider had experienced changes affecting their staffing arrangements. In response, they implemented a business continuity plan to maintain safe staffing levels and minimise any potential disruption to people’s care. The plan set out clear actions to sustain the service and ensure enough suitably skilled staff were deployed to continue meeting people’s assessed care and support needs.

The provider understood their duty to collaborate and work in partnership. They shared information and learning with partners and collaborated for improvement. The registered manager told us they worked collaboratively with health and social care partners. The provider attended local provider forums and network groups. Information and learning from partner groups were shared across the organisation.

The provider demonstrated a commitment to continuous learning and improvement. There were effective systems in place to support organisational learning and service development. Leaders used recent changes to their overseas sponsorship licence as an opportunity to review workforce arrangements, including analysing the care and support people received, staffing levels and potential risks to service delivery. The provider was open and transparent about sharing lessons learnt from this with us which included the reliance on sponsored staff in some areas. The provider responded appropriately by informing commissioners and strengthening contingency planning and governance oversight to ensure continuity of care for people using the service.