Dudley MBC Home Care Services

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 is 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.

The service was in breach of legal regulation in relation to good governance.

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 did not always have a clear culture which was based on engagement. They did not always understand the challenges and the needs of people.

There were instances in which the provider did not always demonstrate a shared direction or support continuous learning and improvement. For example, because there was little evidence care plans and safety events were effectively reviewed, and referrals to external healthcare professionals consistently made, opportunities for the provider to strengthen service culture and direction and engage with others were sometimes missed. This meant people were at risk from a lack of action by the provider to support understanding, learning and engagement.

Leaders worked closely with relatives and staff to create an inclusive culture. There were complaints and equality and diversity policies in place, staff received training in both these areas and told us they were able to speak to leaders should they have concerns.

Staff meetings were held by the leaders which reinforced the values and expectations of the service. Leaders also used satisfaction surveys to obtain the views of staff.

Relatives told us staff regularly consulted with them about the care their relatives received; their views were obtained via their relative’s care plan reviews and satisfaction surveys, and they felt able to raise concerns and were confident leaders would take appropriate action.

Leaders did not always demonstrate the skills and knowledge to lead some aspects of the service effectively.

The provider had failed to identify and / or effectively address the concerns we detailed within sections of this report, which included incident management and care records not always providing information which accurately reflected and mitigated people’s needs and risks. This meant at the time of this assessment, the service was not always managed effectively, and there was an increased risk to people using the service.

There were areas in which leaders demonstrated effective leadership. For example, people, relatives and staff were confident the provider would effectively deal with concerns, staff felt well-supported, and there were some examples of care plans and risk assessments providing good information.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us they felt able to speak up and raise concerns when needed. People and relatives also knew how to raise concerns and felt confident doing so.

The service had a whistleblowing policy in place, and staff were aware of it. Staff told us they felt confident they could raise concerns, should they have any, and the provider would take it seriously.

People and relatives told us people received safe care from staff, and they were confident any issues would be taken seriously and acted upon by the provider.

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

Staff described a positive and supportive environment where individuals were treated fairly and with respect. A staff member told us, “The managers are really good and supportive. Any issues I have, I just speak with my supervisor or the manager, and they do what they can to help.”

Staff had completed equality and diversity training, which supported their understanding of inclusive practice and helped reduce the risk of discrimination, bullying or harassment.

The provider told us they recognised the contribution staff made to the service, and they supported them where they could, such as providing them with reasonable adjustments in their roles to support a positive work-life balance.

The provider did not always have clear systems of good governance.

Effective systems and processes were not in place to ensure safety events were always analysed and care records contained adequate guidance. Systems also failed to highlight the concerns we found relating to staff receiving adequate training relevant to people’s needs. This meant governance systems were not always effective and exposed people to the risk of receiving poor care.

There were examples where effective systems were in place. For example, systems were in place to ensure the application of the Mental Capacity Act 2005 (MCA), the obtaining of people and relative views, staff recruitment and the oversight of staff practice.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people.

With the exception of referrals to external healthcare professionals not always being made when required, the provider demonstrated an understanding of their role and responsibility in ensuring they maintained appropriate communication with external partners.

Safety events were reported to external partners, such as CQC and the local authority, where the provider was required to do so.

Staff supported people to integrate within their local communities and the provider demonstrated examples of communicating with people’s relevant professionals.

The provider did not always focus on continuous learning and improvement across the service.

The provider had not identified and effectively acted on areas of the service which required improvement. For example, the concerns we identified during our inspection and detailed throughout this report. Furthermore, the provider did not always have an adequate awareness and understanding of audit processes and how these could be used to effectively identify concerns and mitigate risks to achieve continuous learning and improvement. This meant there were missed opportunities to learn and make improvements to the overall quality and safety of the service.

However, as detailed within other areas of this report, there were examples in which the provider used audit processes in other areas effectively to mitigate risks and achieve improvements.