Homescare Ltd - Peacehaven

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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

The registered manager was managing three services at the time of this assessment. Staff told us that the registered manager was approachable but not always available. There were areas where the service required improvement for example, formal processes for capturing staff feedback and auditing processes. These were acknowledged by the registered manager but any changes needed time to embed into daily practice. Similarly, the management and oversight of care plans was currently being developed and a process for capturing learning and promoting and sustaining improvements in the service.

This service scored 57 (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 been in post for 13 months. During that time they had identified areas of both practice and process that required work and improvements and they had begun the process of making changes and implementing new ways of working. Although the registered manager was receptive to issues raised there was still work to do for example, reviewing and updating care plans and risk assessments and putting in place a formal structure for staff supervisions and team meetings. All of these processes needed further time to embed and the registered manager, with the support of the local authority, was making progress in these areas.

Business improvement and contingency plans were out of date and related to the sister service. The documents were due for review in January 2024, this had not been completed. The service strategic plan contained details of individual areas of planned improvement for the service however all of the dates shown had passed. Both of these documents needed reviewing and updating. The registered manager acknowledged the need for meetings to include all staff and for a schedule for staff supervision meetings. The registered manager had begun to draw up a schedule for these meetings during our assessment. These improvements again needed time to fully embed.

Despite the lack of formal arrangements, staff told us that the registered manager and deputy were approachable and responsive. Some staff said the registered manager was not always at the service but could usually be contacted if needed. There were out of hours arrangements in place so staff could contact managers if needed during the evening or night. Staff told us that they were also supportive around welfare issues for example staff needing time off at short notice due to child care needs.

Formal processes for supporting staff were being put in place. Whistleblowing and equality and diversity policies were in place to support staff, although not all staff were aware of these. Although communication between the registered manager and their staff was reported as being good, most relatives told us that the registered manager was not visible and did not always respond to their needs. One relative said, “The (registered manager) isn’t that visible on site, but I can contact her via phone.” Another said, “I have had several run ins with her about different issues.”

Staff told us that the registered manager and deputy manager listened when they raised concerns or issues and were responsive in trying to resolve issues. Despite the lack of formal all staff meetings, staff said they had opportunities during the week to approach the managers if they needed to. The registered manager was aware of these concerns and was drawing up a schedule for future meetings.

A residents forum meeting had taken place in November to which eight people attended. It was unclear whether other residents had an opportunity to contribute or ask questions if they could not physically attend. There was a note of the meeting but no action points or date of next meeting. It is not known if the issues raised by people were addressed. People and relatives told us there was no formal process of providing feedback. Comments from relatives included, “I haven’t had anything in the last year,” “No, there are no questionnaire sent out, or meetings that I’m aware of” and “No, not been asked.” Similarly, the registered manager began to take steps to address these issues.

The registered manager explained that they promoted a service where people and staff were treated fairly and without prejudice. People were treated with respect and differences in culture and faith were recognised. A member of staff said, “People are treated equally. We support where needed.” Another added, “Staff are from mixed backgrounds and there are sometimes issues with the older residents. Managers try and deal with this but not easy.”

Systems were in place to support people to celebrate and practice their faith. Two people were taken to church (catholic) during our visit and others attended a different church on Sundays. Equality and diversity policies were in place and staff respected difference and supported people fairly.

Auditing processes and oversight by the registered manager was an area requiring improvement. Although, some auditing was in place for example, medicines. This had failed to pick up on the concerns relating to no photographs on MAR charts, crossings out and no medicine number count. There were no audits in place for reviewing care plans, risk assessments or individual review processes. These concerns were highlighted to the registered manager who began taking steps to review current processes.

Auditing processes were in the process of being reviewed and the new processes needed time to be implemented and then to embed. There was a system for reviewing and maintaining oversight of training. This was kept on a spreadsheet which the registered manager told us they reviewed weekly. This process worked however there were some training modules missing for example, end of life care.

People told us they received the support they needed from health and social care professionals. They also told us that they were able to go out into the community to local shops, cafes and places of worship and that this made them feel part of the local community.

The registered manager told us that they worked well with partners to provide the best outcomes for people.

Statutory partners told us that it took a few interactions with the registered manager before they fully engaged with them. A representative from a partner agency told us it took a while before the managers began engaging with them and working together for the benefit of people living at the service.

Care plans contained some details of key contacts although these were under review. The registered manager told us that they attended forums and meetings with other registered managers and that they kept up to date with changes and developments in adult social care.

Staff told us that they received updates about people’s support needs and any incidents that had occurred through handover meetings. Staff told us there were no team meetings or other forums and that there were no means of capturing any lessons learned when things went wrong or structures for improving the service when things went right. The registered manager was aware of these concerns and was beginning to address this issue.

The registered manager showed us a documented strategic plan for the service. However, this was simply a list of improvements and dates to be completed by. Most of the dates had passed 12 months previously and there was no documented evidence of where the improvements had been made. Similarly, a business contingency and emergency planning document was in place which covered the management of unexpected issues for example, prolonged adverse weather conditions and a future pandemic. This document however had not been reviewed in over 18 months.