City Home Care 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

The provider had a range of audits and quality assurance tools in place to monitor the quality of care being delivered, however these were not always effective as they did not identify areas of concerns we found during the assessment. We found a breach of the regulations in relation to good governance. Staff were able to speak up and felt the service was well managed. The provider worked in partnership with others to assess, monitor and improve the quality of the service. We did not assess all the quality statements within this key question, as we did not identify concerns in the areas we judged as being met at our last inspection.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us the manager was approachable and listened to them. Staff members told us, “The manager and the whole team are amazing. They help staff with training, good communication and respond back to our needs and requests” and “Managers are approachable, provide regular feedback and are available for advice when needed.”

The registered manager had oversight of the needs of individual people and staff. They were suitably qualified and experienced. There was a clear management and staffing structure and staff were aware of their roles and responsibilities. There were processes for leaders to listen and respond to feedback from stakeholders about the service.

Staff told us they were able to raise concerns with their managers. They also told us they were aware of whistleblowing and how to raise a safeguarding alert with external organisations. Managers and staff confirmed there were regular team meetings where staff could raise any concerns about the service.

The provider had policies and procedures that included guidance for speaking up, such as whistleblowing, individual and group meeting as well as speaking directly to the registered manager.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff spoke positively about the registered manager and the support they received through team meetings and supervision. Staff could approach the registered manager whenever they needed to.

Managers were clear about their roles and kept themselves up to date with relevant guidance and legislation. Staff understood their role and responsibilities. The provider had systems for assessing, monitoring and mitigating risk and improving the quality of the service. However, this was not always effective as we identified areas the quality assurance processes did not pick up. This included risk assessments being absent or not detailed enough and consent to care not always being appropriately obtained. Some records did not give enough detail, were not always updated with current information or were not dated. This meant they may not be effective for monitoring and improving the service.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The registered manager explained they kept up to date with best practice and legislation by reviewing the CQC website, attending the local authority registered manager forum and from Skills for Care emails.

The provider had systems for monitoring and improving the quality of the service, but these were not always robust enough to identify issues for learning to take place or to make continuous improvements. For example, incident forms did not always contain information about preventative measures to prevent future recurrence of similar incidents. The reviews of the care plans and risk assessments did not always identify where information was not up to date, for example after a fall, or where risk management plans were required to inform care workers how to mitigate possible risks, for example skin integrity. This meant the provider did not always identify shortfalls in service delivery and was in breach of good governance. Managers carried out spot checks to observe staff, regular staff supervision and gathered feedback from people using the service through telephone calls, visits, and reviews.