Loving Angels Care (West and North Northamptonshire)

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 64 (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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

At the last inspection the provider did not have adequate systems and processes in place to assess, monitor and improve the quality and safety of care provided.

During this assessment we found the provider had made enough improvements and was no longer in breach of regulation. However, further improvements were needed.

Feedback from staff was mixed. Some were dissatisfied with frequent rota changes with shifts sometimes being confirmed the day before. However other staff members described the management team as supportive, approachable and responsive to their concerns. We reviewed the minutes from regular staff meetings, which included a ‘policy of the month’. However, it was not always evident that staff input had been recorded and acted upon.

Throughout this assessment, the management team were responsive to feedback and actioned changes promptly. They were keen to improve and learn. However, the feedback received from people was of concern. One person told us, “One day I was at work, and I think it was the manager of Loving Angels Care called me wanting to get feedback, I told them it wasn’t a good time, but they were pretty persistent. I asked them to call back later but they didn’t. They did however call back a few weeks later asking me if I had received the last invoice, the only contact I have is when they want money." Another person told us, "Not a very professional care manager; wanted to come to the house to drop a folder off. I told them it wasn’t convenient as we had other things going on, other assessments but [Staff] was pretty pushy, so I agreed as long as it was to just drop it off. [Staff] arrived and pretty much pushed their way in, was looking around the house, going from room to room, even asked me to give him the Wi-Fi code as their phone signal was poor. [Staff] made me feel very uncomfortable. Another time [Staff] came and sat on the sofa for an hour, reluctant to leave. It was some kind of review but had finished that and he still sat there. “This was feedback to the registered manager who assured us that appropriate measures would be taken to address the issue.

We were not assured the provider’s values and culture was consistently understood by staff and management.

The provider 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 management team had introduced monthly newsletters for staff and went out to people in their homes for regular reviews.The staff told us they felt supported by the compliance team; however, some staff told us they had not had any interactions with the registered manager. However, we saw evidence of the registered manager conducting staff meetings.

Leaders had worked their way up through the company and told us they felt they had received adequate training for their role and were supported. People told us, "Now and then someone comes out from the office and watches how the carers work and has a chat with me "and Sometimes it's easy to get in touch with the office, sometimes it rings for a long time. Sometimes they will ring to let me know the carer will be a bit late."

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

Staff were able to give feedback anonymously and there was a whistleblowing policy in place.

We saw evidence of duty of candour being implemented within the service. People we spoke with said they would feel happy to raise any concerns they may have. Feedback forms were readily available in their home folders. However not all people were aware they were there.

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.

Staff told us that flexible working arrangements were not discussed during the interview process. However, examples were provided where staff had been supported, for instance, a staff member required flexibility to accommodate school runs. Another staff member with health conditions was able to work from home and a third who was apprehensive about driving was allowed to cycle, with a bicycle being purchased for them.

There is limited well-being support available. The service offered a ‘Well-being Friday’ allowing staff to visit the office and provides access to the blue light scheme for staff working in health and care services.

We raised concerns of staff working up to 60 hours a week. The management team assured us that these extended hours were voluntary. However, we were not assured that adequate systems were in place to monitor and support staff well- being effectively.

The registered manager told us during a previous Eid, a religious event they had underestimated the number of staff requesting time off at the same time, which presented staffing challenges. However, they acknowledged this as a learning point and demonstrated a proactive approach in planning for the forthcoming Eid, taking steps to ensure adequate staffing for the period.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

At the last inspection the provider did not have adequate systems and processes in place to assess, monitor and improve the quality and safety of the care provided.

During this assessment we found the provider had made enough improvements and was no longer in breach of regulation. However, further improvements were needed.

The service is managed by 2 registered mangers and a nominated individual who is the name provider representative; all were aware of their responsibilities. Routine audits and checks were completed. However, the audits were not always effective in identifying areas that required improvement. For example, during the audit of carer notes, the language used by care staff was not reviewed or taken into consideration. We raised this concern with the management team, and they implemented a new audit specifically to address the appropriateness of language used.

Additionally, we noted a discrepancy between the service's Statement of Purpose (SOP) and actual practices. The SOP states that care plans are updated monthly, whereas the registered manager told us that updates occur every 6 months or as required. This was discussed with management.

The management team had a clear understanding of their roles and responsibilities. However, we found not all notifications submitted to us contained sufficient information. For example, we discussed with the registered manager about the lack key details and information recorded in notifications, for example details of any action being taken. Although further information was later provided, it was still not adequate, and we were not assured management fully understood the requirement.

The provider 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.

We saw evidence of effective collaboration with the local authority, particularly in relation to a package of care where loving angels had served notice, as they were no longer able to meet the individual's needs.The management team told us they have a challenging relationship with the district nursing team, who are no longer accepting phone calls from the service. As a result, all communication must be done via email. The management team is actively trying to improve communication and rebuild a more effective working relationship. The service has a good working relationship with the OT. The management team attend various local forums, both West and North Northamptonshire Council forums and the cyber security meetings.

The provider 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 management team demonstrated they were keen on learning and improving the service by responding to our findings during the assessment. The action and improvement plan had been updated to reflect the findings from our assessment, as well as incorporating information from the previous monitoring visit by the local authorities. Regular staff meetings were held. However staff needed to be encouraged to contribute at meetings, which then needed to be recorded in the minutes. People who used the service were routinely asked for feedback to assist the provider in reviewing where any improvements could be made.