Gentle Hands Home Care

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

At our last inspection we rated this question good, this rating remains unchanged. Systems to assess and monitor the quality and safety of the service were in place. Regular checks and audits ensured compliance. However, these needed further development, to ensure they comprehensively identified and managed any potential risks. People were supported to share information with professionals, as required, to ensure their needs were being met. The provider employed a multi-cultural workforce, and measures were in place to ensure staff were treated fairly, yet not all staff felt this was in place.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Most of the staff, did not know the provider’s vision and strategy. The managers were positive about driving the direction of the service, in providing good overall care for people and improving the culture for staff. They were determined to drive improvements further and future plans included scheduling staff meetings which they hoped would start to build more of a team feeling and completing individual supervisions to ensure directives and outcomes were made clearer.

The provider’s values were to ensure good quality care and support were delivered to people who use their services. The managers had a clear idea of the culture they wanted to promote, as well as plans for expanding and improvement. Some actions had already been completed and were shared with us following our visit, further plans were underway.

Feedback from staff about leaders being compassionate and competent was mixed. Time for staff to travel between calls or have a break was not consistently identified. Some staff went from call to call and did not have the opportunity for a break, other staff described regular breaks were included in their rota. Staff did not always have the opportunity for regular supervision and supervision was not timetabled. However, opportunities were there to speak with managers. Managers had plans in place to develop supervision sessions as the staff team expanded.

There were two managers in a job share post, who were awaiting their registration with the Care Quality Commission (CQC). They had a good understanding of how to operate a domiciliary care agency and had a lot of experience. The provider’s manager job share arrangement, senior care worker, and out of hours on-call support arrangement meant there was management support available in depth. They confirmed the provider was very supportive and was easy to contact.

Staff were aware of the process to raise concerns. Feedback received from staff indicated they may not always choose to speak up because they believed they would not get a positive reception from managers. One member of staff who had raised a concern, felt they had received enough feedback to inform them how changes and improvements would be made.

The provider had a whistleblowing policy and procedure document in place. Staff were familiarised with the contents of that policy during their induction training. The policy is a standard document which was downloaded from a policy provider and amended slightly to fit the service. Staff had opportunities to share their experiences and raise any concerns.

The staff team was a very small and diverse team, from a variety of backgrounds and cultures. We received only a small response from the current staff group and their feedback was varied. One person had shared with us their experience saying, “Really, it’s management and communication they need to work on.”

The provider had policies in place to promote workforce equality, diversity, and inclusion. The provider employed a multi-cultural workforce and had measures in place to ensure staff were treated fairly.

Staff knew when and how to raise any concerns. Not all staff felt that management had listened to them. One staff felt unsupported and at times they had been, “left to it” by the organisation; however, another had felt supported. Feedback from the managers, supported by evidence of a range of quality audits; carried out daily, weekly, monthly and quarterly was reviewed and showed compliance.

The provider had systems in place, to monitor the quality of care being delivered. Governance systems were not as well developed as they could be, further improvements were required, for when the managers wouldn’t have as much day to day ‘hands on’ involvement and would need to rely on processes that had not provided sufficient oversight to pick up the areas we found. For example, in relation to recording and evidencing call times and duration; managers assured us of further improvements, immediately following our visit. The managers understood their responsibility for reporting incidents, injuries and other matters to the relevant authorities when they affected people using the service. We reviewed the incident reports for the previous 12 month period as part of the inspection. We saw safe handling and storage of people and staffs' confidential personal information in line with national guidance and legal requirements.

People's views were mixed about whether managers had a good understanding of their needs, but positive about being involved with different agencies to support them. The company was very small and it was found that in the majority, problems could easily be dealt with by the managers or senior carer simply going to cover specific shifts or meet with people/ families etc. The main topic in feedback was for consistency of staff and reliable call times. One relative told us how it affected them, “We worry who is coming to provide care as we had lacked consistent staff; it’s hard when it’s such personal care being provided.” Several told us they felt communication between them and staff had improved recently,” It’s clear when [name] is on, as it seems they hold it all together and things get resolved.”

The provider had developed contacts with commissioners for the areas they covered. We did not receive any negative feedback from partner agencies. Feedback advised when concerns were raised, managers could be reached to discuss and resolve any issues. The managers had a lot of experience in dealing with the other involved agencies including commissioners and healthcare professionals.

Generic policies and procedures had been tailored to the local system. The provider’s manager job share arrangement, senior care worker, and on-call support arrangement meant there was management support available. The managers were knowledgeable about issues and priorities, and aware of GDPR processes and records were seen to be kept securely.

Not all staff were confident feedback would be listened to and improvements were made by the organisation. Some staff described where positive outcomes had occurred for people and described how communication had been shared to prevent previous incidents from happening again. The managers told us all staff were encouraged to speak up with ideas for improvement and given the opportunity to have their say.

There were systems in place to seek feedback from people, however with only a small service the information received was limited. When feedback was provided, plans were made to analyse and develop any actions to learn from these. We reviewed a quality audit around medicines, completed by local medicines optimisation team and found that the managers had already addressed the recommended points.