Care at Home Group Cheshire West and Wirral

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• 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 this key question. Our rating for this key question has improved to good. The provider had systems and processes in place to monitor the quality of the service. There had been a period when governance systems had not been used effectively, however the provider had addressed and was monitoring this. There had been a period of recovery and improvements were being built upon. At the time of the site visit there was a registered manager in post, who was knowledgeable about the people supported and were clear about the areas they needed to focus on to develop the service. However, whilst we have been preparing our report, the provider has advised that the registered manager has left the service. A new manager has since been appointed, who will be applying to register. A wider management support team had been recruited. We found managers needed to embed systems to promote a shared strategy and culture. Feedback indicated the provider was supportive and inclusive, making reasonable adjustments to support the various needs of staff where required. During our assessment we identified an issue in relation to the provider's registration which we are dealing with through a separate process.

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 registered manager had some priorities to promote the delivery of good care, including meeting all people using the service. However, this manager had now left and a new manager had been appointed. Staff told us meetings were sometimes held, and they could call into the office at any time for support or guidance. Information was shared with them through various means.

The provider was embedding systems to promote a shared strategy and culture. The provider held a daily management meeting with all branch managers, with various themes which supported a shared approach. Staff meetings were being held more regularly. The provider held reward and recognition days for staff. With awards to staff who had been nominated as going “above and beyond.” The registered manager had introduced newsletters for staff, which shared guidance, learning and advocated for community engagement and getting involved in charity events, as well as giving thanks and praise to staff.

Staff had been positive about the registered manager and felt she was taking action to address some of their previous concerns. However, whilst our report was being prepared, the provider informed us she had left the service. They have now appointed another new manager. Some staff felt previous management and office staff changes meant some issues had not been dealt with, but that the previous manager had been trying to make necessary changes. Staff commented, “I’m happy with the way things are managed, I love helping people, so I’m happy” and “I’m happy with this company. If any difficulty we can ring to the manager, she sorts out everything.”

The provider had recruited to various roles to support the management of the service, including a deputy manager and care coordinator. The provider understood the requirement to notify CQC about certain incidents and events. There was a process to record these. However, one safeguarding concern had been reported to the local authority and addressed, but CQC had not been notified as required. This had been an oversight, and we have subsequently received appropriate notifications.

Staff said the registered manager was approachable and accessible. Meetings were arranged and staff were encouraged to call into the office. They told us, “If we need anything we can contact the manager. She is really nice; we can freely talk to her”; “There are meetings, and you can pop in. If any issues you can go and have a meeting” and “If you feel you need more training, they always say just let us know.”

The provider had a whistleblowing policy in place. Staff were given opportunities to speak up and share their views through various means, such as supervision or team meetings. Managers had an open-door policy and encouraged staff to visit the office if they wanted to discuss any issues.

Feedback indicated the provider was supportive and inclusive, making reasonable adjustments to support the various needs of staff where required. The registered manager told us she actively encouraged staff to discuss any needs they had. A staff member said, “Everyone is fine, due to [manager]." However, the registered manager has subsequently left and a new manager appointed.

The provider valued diversity. They had an equality and diversity policy. Staff undertook training in equality and diversity as part of the Care Certificate standards. Managers had identified the need to support staff with further training and guidance, including training around potential cultural differences, such as with cookery courses. Newsletters to staff included celebrations such as “Pride” and various religious celebrations such as Eide.

The provider acknowledged there had been a period when governance systems were not being used effectively. The operations manager told us their governance framework was now back in place and they were monitoring this monthly. There had been a period of recovery but now believed the foundations were in place for the current manager to build on. Staff told us various checks and audits were carried out, including medication and care records. Feedback from some people noted improvements were being made by the new manager. A staff member said, “They have done 2 spot checks, when I started work after 2 weeks came to [names] house for spot checks. Then I had someone shadowing me and they did a spot check.”

The provider had systems and processes to monitor the quality of the service. They had recently taken action to ensure these were fully used and monitored. There were various audits, checks and trackers to keep oversight. Quality monitoring calls to gather feedback from people were being undertaken on a more regular basis. The improvements needed to be embedded and sustained. The service had worked with the local authority on an action plan to make required improvements to the service. The local authority had seen some improvements overall. During the assessment we identified a potential issue in relation to the provider's registration and we are dealing with this separately.

People received care from a service who worked in partnership with other agencies to improve outcomes. Surveys and reviews were undertaken to gather feedback to help make improvements to the care provided.

The registered manager understood their duty to work collaboratively. She worked in partnership with various other organisations, such as Skills for Care. We have been informed since the site visit that the registered manager has left the service.

The local authority told us the service had worked in partnership with them to make improvements to the service.

The provider and manager understood their duty to work collaboratively. They now had more robust systems of oversight in place and were monitoring these.

Overall staff told us they felt supported. Some felt frequent changes to the management team had previously impacted on staff and the stability of the service. Staff and people were positive about the current manager coming back into post, who had now registered. A relatively new management team were in place and supporting the leadership of the service, enabling the registered manager to focus on oversight and improvement.

The provider had processes in place to help the service to learn and improve. The provider had an action plan for improvement which they had monitored over the past few months. Since our previous inspection, they had contacted all employees to enable them to provide feedback about the service delivery. There had been a focus on training and medication administration. Team meetings were planned on a regular basis and regular communications sent out to staff. Some themes identified at our previous inspection which were still being worked on including the punctuality of care calls times/regular staff and people being able to contact the office effectively. Managers had kept an oversight of any complaints, and other incidents with actions taken in response. Where appropriate, information was shared with the staff to ensure learning and development.