First Homecare - North London

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 inspection for this service. This key question has been rated requires improvement. This meant the management and leadership was inconsistent. However, leaders and the culture they created promoted 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 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 registered manager and director demonstrated a positive, compassionate listening culture that promoted trust and understanding between them, people and their families and the staff team. The registered manager told us this was discussed with staff from the start of their employment journey and highlighted how they wanted to make sure they looked after people with care and compassion. They added, “We are open and honest. We encourage a culture of openness and are always wanting to get feedback from staff and people about how we can improve."

Not all leaders understood the context in which the provider delivered care, treatment and support. Whilst they embodied the culture and values of their organisation with integrity and honesty, managers/ leaders did not always have the knowledge or understanding to ensure the service provided safe and effective care in line with best practice guidance. For example, the provider was not fully aware of their legal requirements related to recruitment practices. There were also shortfalls around best practice in relation to care planning, assessing risk and people’s mental capacity. However, feedback was very positive about the management team and their ability to provide competent staff and manage the service. A relative added, “Over the years, we have had different carers from different agencies, but this is the best one we have ever seen. We have never had a problem at all."

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us they were always reminded and encouraged to raise any concerns they had. Staff were very confident they would be listened to, and their voices would be heard. There were positive responses with staff survey records, which showed the management team were supportive and gave staff the time to express themselves. A staff member added, “Their communication is excellent. I can discuss anything, and they give me the space to talk about what is good for me, checking how I am. This is very good."

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 confirmed they had regular contact with the management team and praised how they were treated and the positive and inclusive work environment. A staff member added, “They give us what we need to make us comfortable. I am treated fairly, equally and they are open with me. It is a good organisation and I have never had any issues with them.” There were positive responses with staff survey records, which showed staff were involved and changes were made based on staff feedback and suggestions.

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. The providers audits and quality assurance processes were not always effective in identifying areas for improvement. This was in relation to people’s medicines records, recruitment processes and how the provider sought and recorded consent in line with best practice. Furthermore, care planning audits had not identified the shortfalls we found at this inspection regarding the level of detail and assessment of risk within care records. Whilst we found no evidence that people had been harmed, the registered manager acknowledged the shortfalls and told us they would look to address this immediately. Despite this, a relative and both care staff confirmed the management team carried out regular home visits to monitor the service and always sought feedback.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. Although the registered manager was registered with several networks within the health and social care for support and guidance, they had not worked in partnership with all the relevant external stakeholders and healthcare professionals, where required. We discussed this with the registered manager during the inspection. We received confirmation on 19 February 2025 the registered manager had followed up with a relevant health and social care professional after the inspection.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always actively contribute to safe, effective practice and research. Whilst the provider had invested in a digital system to help improve the monitoring of their service, quality assurance systems needed further implementation and development to ensure they were effective in identifying areas for improvement. Despite this, staff provided positive feedback about how the management team involved them in the service and were proactive in listening to their ideas on how the service could be improved. A staff member added, “One of the best things is they will always listen and they are always available."