Care at Home Group Cheshire East and West

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

We assessed 7 quality statements under the well-led key question, identifying both areas of good practice and areas of concern. The overall rating for this key question is requires improvement. We found 1 breaches of the legal regulation non-reporting of safeguarding events to CQC. While audits and checks were in place, they did not identify all failings found during our assessment, including issues with medicines management and the reporting of events to the CQC. The management team acknowledged these shortcomings and had taken actions to address some of the concerns. Further work is required to embed improvements into practice, including areas highlighted during this assessment. Staff generally described the manager and senior office staff as approachable. Many noted improvements in recent months, although some expressed that further progress was needed in communication about people’s care calls and staff support. The manager is continuing to address these issues to drive ongoing improvement.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team felt well supported by the senior leadership at Care at Home Group and recognised continued improvements were being implemented. Staff spoke openly of some of they challenges the face where they felt that the provider needed to make further improvements. We were told, “We love our company, but we want things to be done proper in the office for the client and the carers” and, “We need that quality from the office to produce quality of care.”

The manager had a plan and vision about how to improve and develop the service. Since coming into post, they had worked to improve communication throughout the service, introducing more regular staff meetings and ensuring individual meetings were being carried out. They were in the process of getting out and meeting people who used the service.

Staff felt confident in the management team in the office and shared situations where they felt that this had improved in some areas. Comments included. “Perfectly supported,” “The management team are always fair and approachable” and, “Things are improving.” However, some feedback suggested further improvements could be made. We were told, “I’ve mentioned things, but it never is and just continues.” This feedback was in relation to challenges around travel between care calls.

The current manager had moved to the service a few months ago and had applied to register with CQC. The manager was open and transparent during the assessment process. They had taken various actions since coming into post and had a plan about actions they needed to take to further improve aspects of the service. However, the provider and manager had not always ensured all regulatory requirements had been met. They told us they would take action to address this moving forward. The provider was in the process of recruiting to support the management/office team. There had been times where the manager and deputy manager had been required to provide direct care to people. Moving forward the manager aimed to have more capacity to focus on the management and leadership of the service.

Staff felt they could share feedback and concerns with the office staff. Many shared this was an area that had improved in recent months.

The provider had a whistleblowing policy. Staff were given the opportunity to share feedback in various ways. Some team meetings had been held, but had not always been well attended. The manager had planned monthly meetings at various times to support staff to be able to attend. Staff were supported to have an intervention such as supervision of field observations every 3 months where they could raise issues or provide feedback. However, some of these had fallen behind. The electronic recording system now enabled staff to send messages or share any concerns. The manager was fostering an open culture, but this needed to be fully embedded.

Overall staff spoke of an inclusive workforce where they felt valued for doing the work they completed for people who used the service.

The provider valued diversity. They had an equality and diversity policy in place. Staff undertook equality and diversity training as part of their mandatory training. Where people had given feedback about their care, managers had responded to support staff with further training and guidance, including training around potential cultural differences in relation to foods and cooking.

The manager was aware of the people’s feedback and some of the issues raised with us during the assessment. They told us they had and were continuing to take action to continue to improve the quality of the service. Staff confirmed members of the management team undertook spot checks and completed competencies on their ability.

The provider had not ensured that CQC were notified about all incidents as legally required. Several safeguarding enquiries had been undertaken with the local authority and appropriate action taken to deal with these issues. However, we found not all safeguarding enquires had been submitted to CQC. The provider confirmed they would put a system in place to ensure they complied with this requirement in future. The provider had systems in place to monitor the quality of the service. These systems supported various reports and analysis, and some audits were completed. However, there appeared to have been a lapse in these processes and the provider’s oversight had not identified this until several improvements were required. A detailed audit undertaken by the provider highlighted areas of improvement. The manager and provider had developed an action plan, and taken action, which was being monitored by the provider’s own quality team. The provider had developed a weekly governance planner to monitor various aspects of the service.

Feedback we received from people indicated that the provider worked with external partners where required, or when requested by the person.

Managers were aware of the importance of working with local communities. The manager told us about a local initiative they were involved with, to help support the local environment. Staff from the service volunteered to support the towns local cleaning team with litter picking and keeping the area tidy.

The provider was working with the local authority to make improvements. They confirmed progress had been made however, further improvements were required to demonstrate changes had been imbedded into practice.

The provider understood their duty to collaborate and work in partnership. They worked with local authorities and had responded to address areas identified for improvement, following a recent local authority assessment. The provider had a scheme to encourage staff to work in partnership with the local community. Staff were asked to volunteer at a place of their choice every 4 months and the provider continued to pay them There were examples where staff had volunteered at local food banks and dog kennels.

The manager told us they were supported to focus on learning. The provider held meetings with staff across the organisation to focus on improvements and shared learning.

The provider had focused on learning and improvement across the organisation. There were examples where the provider had identified that improvements were necessary, and some actions had been taken. For example, data had shown some difficulties for staff when accessing the system to log call times accurately. The provider had made some changes so that staff logged in more accurately using a QR code in people's homes and were closely monitoring this. However, the processes had not identified some of the issues we found during our assessment and systems for ongoing improvement needed to be fully embedded.