Dignity Direct Homecare Ltd - Sheffield

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 assessment for this newly registered service. This key question has been rated requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The service was in breach of legal regulation in relation to the governance of the service.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were clear visions and values for the service, which were reiterated in team meetings. Staff received inductions and regular supervision. We received mixed feedback from staff re the culture within the team. One staff member said, “Yes and no (feel supported by my manager). They have helped me with some things, but at other times have been rude to me.” Whilst the majority of staff told us the manager was approachable and fair. One staff member said, “Staff morale is generally positive, with strong teamwork and support.” Staff received regular spot checks to ensure they were adhering to policies and procedures and were provided with a staff handbook. Such as medication practice, IPC practice and interactions with people. However, we could not be assured these were always effective due to the concerns we found during this inspection.

Not all leaders understood the context in which the service delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. We found incidents which were not reported to the CQC as required. We received mixed feedback from staff regarding the leadership of the service. Most staff told us the managers were approachable and fair; however, some staff told us they did not feel listened to and were not confident in the leadership. We received mixed feedback from people and relatives about the service being well led. One person said, “I’ve no idea who’s in charge. To be truthful it’s badly run. It should be organised. My family said it’s a waste of time them (carers) coming out late at night time as I’m already in bed.” Whilst another person said, “The manager came to see me. The manager was lovely. A very nice lady who explained everything.”

People did not always feel they could speak up and that their voice would be heard. There were clear whistle blowing policies and procedures in place. Most staff told us they felt able to raise concerns and these would be acted upon. However, some staff told us they lacked confidence in the leadership team that concerns would be actioned. One staff member said, “I feel comfortable whistleblowing if necessary and would report to my manager, safeguarding lead, or external authorities like the CQC. I haven't had to whistle-blow.” Whilst another staff member said, “I had to report someone missing, no one thought this was concerning and I had to go to the provider for action to be taken.”

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them. The service benefited from a diverse workforce, and some staff were sponsored from overseas. All staff were supported with their professional development. No staff raised any concerns with us regarding discrimination, however some staff told us they did not feel listened to.

The service did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The provider had failed to ensure all staff were recruited safely, we found a delay in obtaining a DBS for a staff member, this person's DBS also contained concerning information which could place people at risk. The provider had carried out a risk assessment for this staff and this person was no longer employed by the service. This was discussed with the management team at the time of our inspection and we were assured they had learned from this and would ensure people had DBS checks prior to commencing employment. Audit systems were in place; however these were ineffective in identifying the concerns we found during our inspection, in relation to medicines, safeguarding, managing risks and records. The provider was actively involved in the day-to-day operations of the service and visited the service regularly.

The service did not always understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. The management team held quarterly meetings with professionals and commissioners to discuss any concerns and agree on actions required. They also held regular meetings with district nurse teams and social workers. We received positive feedback from partners about how the service worked with them. However, we could not be assured the service always worked with external professionals, due to the concerns we found in the safe section of this report. Some people told us the service could be better run.

The service did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research. The service had undergone a transformation since registration and was providing support to a large number of people. This had caused some challenges for the service and staff team. The provider was keen to drive improvements in the service and continue to improve care plans and risk assessments. Improvement plans were in place and ongoing, which included improving staff punctuality and communication, auditing systems and staff recruitment.