- Homecare service
Kensington Home Care
Report from 25 April 2024 assessment
Contents
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
The registered manager and office team had developed a positive culture which embraced change and improvement. They understood people’s needs and were responsive to feedback and the need for improvements in certain areas. They had overcome a range of challenges since taking over the service and built strong links with external partners. There were effective governance and management systems in place to monitor and reduce risk, and to find ways to improve the service.
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.
Staff felt they had pulled together to get through some challenges, and were well placed to continue to improve the service. One staff member said, “The managers are fabulous with a total commitment to effective and efficient service delivery to services users.” External partners had confidence in the direction of the service and the team that led it. They recognised the hard work put in by the team and the progress to date. They felt the culture was hard working, centred on people’s needs and reflected in outcomes. One told us, “The registered manager certainly inherited a few issues and has since she came into the post worked extremely hard on implementing improvements. Theses have not only been to the benefit of clients/families but also her staff.”
The registered manager did not have in place a formal action plan to prioritise improvements and ideas – they recognised this would be beneficial. They did however demonstrate significant improvements against a range of areas identified through visits from external partners, where they had acted effectively to ensure the improvements were made in a timely way. The service adhered to its aims and objectives, as set out in its Statement of Purpose. These included providing a service that “enables service users to live independently in their own homes, ensuring health & safety and assistance when required.”
Capable, compassionate and inclusive leaders
Staff felt included in the direction of the service and valued for the work they did. One staff member said, “The management is employee oriented. What I mean is that they look after us the workers and also pay special attention to our clients. Their management style creates a safe working environment for us the employees.” All external partners we spoke with had confidence in the leadership of the service. They had experienced a registered manager who role modelled the behaviour they wanted others to demonstrate and had the necessary experience, competence and drive to manage some challenges on taking over the service, and then continuing to improving the service.
The registered manager demonstrated a strong understanding of what was required to effectively run the service. They were aware of the risks presented and how to reduce them, for instance in relation to staff turnover, cultures becoming closed off and cliques developing, and poor habits/practice developing. They protected against these by using unannounced spot checks and supervisions. The service supported staff with career aspirations to pursue relevant qualifications.
Freedom to speak up
All staff we spoke with felt able to raise concerns without any fear and with confidence concerns would be dealt with appropriately. Partners had confidence in the provider’s systems and processes to enable people and staff to speak up where they had concerns. They had experienced the registered manager’s open approach when there were concerns, and praised them for the level of scrutiny and learning they applied after one incident.
The provider had up to date whistleblowing policies in place and other means to capture staff feedback that may need acting on, such as staff meetings, supervisions and spot checks.
Workforce equality, diversity and inclusion
The registered manager embraced diversity of staff and there were examples of staff and people who used the service bonding over shared (and new) experiences. No staff raised any concerns about bullying or unfair treatment, and praised the office team. No partners raised any concerns about bullying or unfair treatment, and praised the approach of the service.
Processes were in place to ensure recruitment practices were fair, and the registered manager clearly valued the diversity of the staff team. More needed to be done however to support these new staff, with a range of cultural backgrounds, to ensure those backgrounds were understood by all and to ensure possible shared experiences were found with people using the service. There were clear processes and actions in place for when there was a cultural clash between a person using the service and a member of staff but more needed to be done to formal explore the possible positive connections, particularly in relation to food preparation. The registered manager was responsive to these findings and was already liaising with external partners about this during the assessment.
Governance, management and sustainability
The registered manager had plans in place for growth at a manageable rate, ensuring that any increase in caseloads did not negatively impact on people or staff. They were clear they wanted the service to be stable before growing the service, and they had achieved this for the most part. Partners fed back that staff always had time for them and were always accessible when needed. They had shown a level of flexibility that meant they were not taking on more than they could manage in terms of care packages. The service provided external partners with the information they needed to enable proper external scrutiny and oversight.
The service’s auditing arrangements were proportionate to the size of the service. The 6 month quality reviews formed a significant part of the provider’s oversight of people’s experience, with the visiting officer also reviewing care planning information and updating where relevant. The registered manager acknowledged they would need more capacity to support with auditing and oversight should the service grow significantly.
Partnerships and communities
People’s experience of the provider’s partnership working was limited, as they largely were not party to it. They raised no concerns about times when the provider had linked in with external professionals, such as nurses or Occupational Therapists.
The registered manager had built up a range of positive, mutually respectful relationships with external partners. The registered manager engaged well with local teams and suggested ideas for innovation and improvement at provider forums. The registered manager acknowledged there were more opportunities to try and link the service in with other community groups and services, as well as with those health and social care agencies they had already made links with.
Partners agreed that the service worked collaboratively with them to improve the service and to achieve good outcomes for people.
The registered manager regularly attended provider forums to help keep them up to date on what others were doing and to build networks. Policies were informed by national good practice and more local schemes, and were reviewed regularly.
Learning, improvement and innovation
The registered manager reflected on incidents and demonstrated that they reviewed processes when things did not go to place. For instance, the electronic records system had not previously worked alongside medication and rota recording, so they had introduced a new system. This was still bedding in at the time of our visit but it demonstrated they were willing to change when IT systems were not delivering the outcomes they promised. The registered manager planned to make contact with the local university to see if there were any mutually beneficial studies they could contribute to. Partners confirmed that the leadership were open minded to change and regularly sought improvements. “Staff did have limited knowledge around specific conditions, however were open to seeking out and taking on board recommendations from OT with how to meet clients’ needs and moving and handling techniques.”
The provider had in place clear policies that enabled reflective learning from incidents through consistent reporting and action. The registered manager’s review of and subsequent change of IT systems, alongside working with local partners, led to a range of improvements in the accuracy of medicines management. This had a direct positive impact on people. The registered manager hoped to be able to have a similar impact on the consistency of call times with a thorough review and relevant learning.