HFH Healthcare Limited

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 inspection, we rated this key question good. At this inspection, 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 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service 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.

Managers described the values of the provider and explained how these were applied to ensure they employed suitable staff. Managers told us they routinely used individual and group meetings to remind staff about the provider’s underlying core values and principles. They supported a reflective practice approach, establishing a learning culture to support staff to deliver good quality, person-centred care. Care staff told us they were supported by the office-based managers and staff to deliver consistently safe, person-centred care to people in line with the provider’s vision and values for the service. All staff received an employee handbook which set out the provider's philosophy, policies and procedures, and expectations regarding their behaviour at work. A member of staff told us, “HFH treats us fairly and promotes equality and respect. The culture is inclusive, supportive, and focused on delivering high-quality, person-centred care.” Another member of staff added, “People we support with complex health care needs have a designated team of carers and nurses who routinely provide their care. The small team I work in has a very good team spirit and we always support each other.”

The provider had clearly stated values and aims about the quality and safety of care and support people could expect to receive from them. Staff were familiar with the provider's values and aims.

The service 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 service had a suitably skilled, knowledgeable and experienced management team. They had a registered manager in post who was supported by various directors and heads of departments including nursing, operations and compliance. Feedback we received from people about the leadership approach of the managers and other office-based staff was positive. A relative told us, “I feel the managers and all the staff in the office do a good job running the agency. They make sure we get the right carers when we need them.”

Staff were equally complimentary about the leadership approach of the management team who they consistently described as approachable and professional. A member of staff told us, “I always feel supported by the office-based managers, nurses and care coordinator. They are approachable and available when I need help, whether it’s a clinical concern, emotional support, or guidance on procedures.” Another member of staff added, “I know our own nurses are only a phone call away and are always there to offer us help and advice whenever we need it.”

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

The provider had an open and transparent culture where people receiving a home care service, their relatives, external care professionals and staff working for the agency were all encouraged to raise concerns without fear. The provider used a range of methods to gather people’s views and experiences of about the service they received. This included regular telephone contact from office-based staff, nurse-led quality monitoring visits to people's homes, care plan reviews, service user forums and satisfaction surveys.

People told us they felt able to speak freely with the office-based managers and staff or the nurses and care staff who regularly visited them at home if they wished to discuss the quality and/or safety of the care and support they or their family member received. Typical feedback we received included, “They [officed-based staff] do regular welfare checks via the phone to ensure that I’m happy with the service I receive and with the carers who deliver it. The nurse in-charge of my region also comes to visit me at home regularly to check how I’m doing. They always ask if I ever have any concerns or if there’s any changes to my health they need to be aware of. They always take my feedback seriously,” “Once a month I complete a survey to HFH about my care and they also ring up regularly to see how I’m doing. The nurses often visit me at home to see how I am” and “The staff who provide our care are always extremely helpful and the staff in the office phone us regularly to check how we are. We also get regular home visits from a HFH nurse who is also extremely helpful and supportive”.

People were given a copy of the providers' complaints procedure when they first started using the service which set out clearly how people could make a complaint if they were dissatisfied with the service they received and how their concern would be managed by the provider. People told us they knew how to make a complaint if they were unhappy with the standard of home care they received, and that the process was easy to follow. A person said, "If I had the need to complain about something (which happens very rarely) I know that my concerns would be taken seriously and dealt with. I have no issues with HFH, but would feel comfortable about raising a complaint if I had to." Another person added, "If we have any concerns or questions we know our care coordinator is only a phone call away."

The provider valued and listened to the views of staff. Staff were encouraged to contribute their ideas about their experiences of what it was like to work for this provider. This included regular individual and group meetings with their line managers and fellow co-workers, staff forums, team building/away day events, staff newsletter and satisfaction surveys. There was a staff ‘Speak up’ policy and staff told us their views were always taken seriously and acted upon by the managers. A member of staff said, “We are encouraged to give feedback through regular team and 1 to 1 supervision meetings with our line managers and to complete an annual staff satisfaction survey. For example, when I suggested more training on dementia care, additional sessions were arranged, showing that management values our input.”

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff told us they were part of a diverse team and felt they were treated equally and fairly. Staff told us their line managers and other office-based staff were always supportive and they felt respected, valued and listened to. A member of staff remarked, “Managers and nurses from our offices regularly visit us while we’re on shift and ask how we are.”

Managers understood the importance of having a fair and inclusive workplace for all staff to work in. Staff were provided support through relevant training and supervision to inform their knowledge and understanding of equality, inclusivity and fairness in the workplace.

The service 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 act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Governance systems were well-established, effectively operated and used to regularly check and audit the quality and safety of the care and support people received. The outcomes of these checks and audits were used to identify performance shortfalls which feed into an action plan to improve the quality and safety of the service people received. Various directors and heads of department regularly met to discuss identified issues and agree action plans to resolve any identified issues.

Managers and other office-based staff demonstrated a good understanding of their governance roles and responsibilities in relation to assessing, monitoring and managing the quality and safety of the service they provided. Nurses told us they regularly carried out home monitoring visits to observe staffs working practices during their call visits/shift in people’s homes. These checks looked at various aspects of staffs roles and responsibilities including, their timekeeping, attitude and interaction with the person they were supporting and their relatives, the safe use of medical equipment, medicines management and record keeping. A member of staff said, “Managers and nurses from our offices carry out regular spot checks on us while we’re on shift to ensure best working practices are followed.” In addition, managers would meet daily to share any concerns that had been identified from the previous 24 hours and agree actions to be taken in response to minimise the risk of similar issues and/or incidents reoccurring.

Managers understood their responsibilities in relation to regulatory requirements around notifiable incidents. The provider continued to notify the CQC in a timely manner about any incidents and events they were legally required to.

The service's previous CQC inspection report and ratings were clearly displayed in the providers offices and was easy to access on the provider's website. The display of the ratings is a legal requirement, to inform people, those seeking information about the service and visitors of our judgments.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The provider shared information and learning with partners and worked closely with services to continuously improve. Managers and staff told us they worked in close partnership with various external health and social care professionals and bodies who they regularly consulted and welcomed their views and advice. This included multiple NHS Trusts and hospitals, clinical commissioning groups, continuing health care teams, local authorities, hospices, community centres and charities located in London and South East England. A member of staff told us, “I am constantly collaborating with GPs, district nurses, physiotherapists, and social workers as and when I need to. For example, I followed a physiotherapist’s care plan for a client recovering from a fall, which helped in their rehabilitation.” Another member of staff added, “I know I can rely on the district nurses and call them anytime for advice and support. We do have a fantastic working relationship with all the community health care professionals in the area, including the district and palliative care nurses.”

The service 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 contribute to safe, effective practice and research.

Managers understood the importance of having an open culture of learning and continuous improvement to ensure people consistently received high quality, safe care and support. Managers told us all the audits and checks the provider conducted were routinely analysed to identify performance shortfalls and learn lessons, so the service could continuously improve. When lessons needed to be learned, the provider developed action plans which set out clearly what, how and when they needed to take steps to improve the service they provided people. Staff confirmed information about any lessons learnt and action plans developed as a result were always shared with them during individual and group supervision meetings with their line managers and nursing staff.

Managers understood their responsibility to apply duty of candour and where appropriate apologise when things had gone wrong. The duty of candour is a legal requirement for health and social care providers to be open and transparent with people receiving care and treatment when mistakes occur.