Care at Home Gloucester

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.

This is the first assessment for this registered service. This key question has been rated 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 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.

The management team built a culture that focused on enabling people to enjoy a full life. Staff described a supportive and open culture which confirmed the service’s values were at the heart of their role.The model of care was in line with current best practice guidance such as Right support, right care, right culture. Staff learning and reflections on outcomes were discussed across a range of forums, meetings and supervision, with a whole staff team approach. Staff in all roles expressed a great sense of pride in working for the service and the care and support they provided.

Some staff had found the recent changes to staff roles, re-organisation and re-structure of the service difficult. This included working with new staff and managers under new guidelines and systems. The senior management team were aware of these difficulties and were actively supporting each home manager to aid the transition for staff teams.

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 service was run by highly capable, skilled and passionate leaders and managers. The registered manager was visible and approachable. The majority of staff said they were very well supported and worked well as a team in the best interests of the people they supported.

Managers were supported to undertake additional management training so they could excel in their role. Managers were also trained (via a train the trainer approach) in specific areas such as Positive Behavioural Support and were able to role out the method across all staff teams within the service. Staff at all levels were encouraged to progress and develop their careers in social care. Some staff had already progressed and obtained promotions within the service. Staff retention was good.

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

The provider had a whistleblowing policy, information on whistleblowing on staff payslips, a 24-hour helpline and a wellbeing staff guardian. Staff were encouraged to voice any concerns. Staff comments included, “Yes definitely we have a right to do this. I have not had to do this. I know there is a number on our payslip and the policy states that we[will be]protected”, “Our manager's line is always open, even at night so we can always ask” and “Yes I can raise concerns to my manager. I will hand over to seniors in the first instance and it is rare I need to go to my manager, but I feel like I could.”

However, some staff had not had a good experience in the past and told us there were ‘cliques’ within the different staff groups which had resulted in a negative atmosphere. We raised these concerns with the registered manager who was aware of the situation and had already started to address the concerns.

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.

The provider valued the well-being of staff. There was an up-to-date recruitment policy and the service employed a diverse team of British and overseas staff as part of the UK Government sponsorship license scheme.

The majority of staff we spoke with were very happy in their role and felt supported and involved by the service and managers.

Comments from staff included, “I love it. First care job. I'm proud working here. I get on with everyone and all the staff”, “Very nice working here. [Manager] is very open and you can raise any concerns and he will listen. They are very flexible if I have any issues with childcare then I can tell them and they will sort some flexibility out for me with my shifts etc.” and “[Manager] is very supportive and [the provider] is also very good they make me feel like a valued staff member. I am very happy.”

The provider 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.

There was a clearly defined governance structure which included different stages of management support and audits and checks at multiple levels. Manager’s audits were detailed and comprehensive, and included regular visits to people’s homes. Observations and discussions with staff and people using the service formed part of their checks.

The systems in place ensured the quality and safety of care provided to people remained consistent. A clear staffing structure facilitated line management for both staff and people who used the service.

Regular meetings were held to share any changes and discuss any issues, as well as identifying areas of good practice and good outcomes. Staff had received comprehensive, regular and bespoke training and clearly understood their roles and responsibilities.

Audits were carried out regularly, including weekly, monthly, 6 monthly and annually. Where shortfalls were identified they were promptly acted upon to ensure they were addressed, improvements made and people received good care and support.

The service had a quality manager who carried out regular checks and informed an overall service improvement plan.

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.

Staff and managers worked well with other health and social care professionals, and services to support people with complex needs and risks. Good, collaborative working relationships had been developed which was confirmed by the professionals who provided feedback.

Comments included, “I find the management team to be easily contactable. I found all staff to be professional, polite and friendly” and “Management have been accessible when needed and responsive to communication.”

The provider worked in partnership with the local authority and health and social care professionals to provide safe and effective care for the people they supported.

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 provider had learned from past events and had introduced a robust system to monitor and manage people’s support, with an assessed risk relating to choking. This included comprehensive training for all staff in dysphagia and choking, person-centred care plans for individuals assessed as at risk, and close collaboration with SALT and the dysphagia service.

The provider had also trained all members of staff in Positive Behaviour Management and support as a proportionate method to understand and manage behaviours of distress.

Training compliance was very good. The provider used a matrix to show which training had been completed, when it was next due and if any staff were over-due.

All staff spoke positively about the training programme provided. Comments included, “Training is really good. We get specific training to the needs in our home for example PEG [percutaneous endoscopic gastrostomy]. We are always told that we should express if we feel we need more training in an area”,“They updated us with online courses, we are constantly being trained. We can request any course that we would like”and“Training is really good. We do face to face as well online.”

Learning lessons and outcomes were discussed across a range of forums, meetings and supervision, with a whole staff team approach. Staff in all roles expressed a great sense of pride in working for the service and the care and support they provided. The model of care was in line with current best practice guidance,Right support, right care, right culture. The management team built a culture that focused on enabling people to enjoy a full life.