Prime Care Domiciliary Essex

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 was their first assessment. We assessed a total of 7 quality statements from this key question. We have rated this key question 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. During our assessment of this key question, we found concerns around the provider's systems and processes. We found a breach of the legal regulation to governance.

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 operations manager recognised improvements were needed to ensure governance and leadership was more robust and effective in managing the day-to-day quality assurance of the service. This would ensure all actions identified in quality audits were followed through and sustainability was embedded into the service.

The management team had clear values and were aware of the direction they wanted to take. The registered manager had developed a listening culture where staff can feel they are available for them to talk to. Staff were asked to complete a survey to give their feedback on the support they received. However, the registered manager had not reviewed the staff surveys to see where improvements could be made.

The registered manager was unavailable on the day of the assessment. There was a clear staffing structure in place. The operations manager had recently appointed an administrative lead who was implementing change. The operations manager acknowledged changes were required to make improvements to their service.

The registered manager was clear about their roles and had the skills, knowledge and experience to perform their role. The registered manager felt supported by the operations manager. However, we found limited evidence to show the operations manager had carried out robust audits and processes. The audits carried out lacked detail and were mostly a tick box exercise. We were not assured the operations manager had good oversight of the service.

Staff felt supported to speak up and discuss any concerns they may have during team meetings or supervision. A member of staff told us, “The manager has an open-door policy, and I can speak to them whenever I need to. I don’t always have to wait for a meeting if there is something I need to discuss.” However, the staff supervision matrix indicated staff did not have supervision regularly. This meant there were no effective arrangements in place to monitor staffs' practice, performance and professional practice.

The registered manager had policy and processes for staff to follow on ‘whistle blowing’. Staff meetings were being held regularly. We reviewed minutes and saw they included information about the service as well as reminders about training, staff rota’s, safeguarding and PPE. However, there were no action plans completed to evidence how issues raised were to be addressed, dates to be achieved and if actions had been resolved or remained outstanding. The registered manager had not sent out recent surveys to people using the service to gather feedback about the service. The operation manager told us they carried out regular telephone monitoring calls. However, there was no formal record of discussions that took place following the calls and results were not always analysed for themes or trends.

There was a policy in place to protect staff from harassment and bullying and a focus on protected characteristics under the Equality Act.

The registered manager had developed an inclusive workforce and recognized the value of diversity amongst the team.

Staff we spoke to told us they were able to speak up freely and were provided with various avenues to do this. All staff we spoke with were aware of the providers whistle blowing policy. Staff told us they had supervisions, but these were not completed regularly.

The quality assurance and governance arrangements in place were not always effective in identifying shortfalls at the service. The audits carried out by the registered manager lacked detail and were mostly a tick box exercise and did not identify the shortfalls we found. This meant effective auditing arrangements were not in place to assess, monitor and improve the quality and safety of the service provided. There was no formal record for how the registered manager learnt from lessons following incidents. Staff meeting minutes did not include action plans completed to evidence how issues raised were to be addressed, dates to be achieved and if actions had been resolved or remained outstanding. Statutory notifications were also not being sent to CQC as required.

Most people and relatives told us they worked in partnership with the management and other health professionals. However, a person told us, "I don't know who the manager is. I am not sure."

The registered manager had developed good links and worked closely with health professionals and the local authority to ensure seamless care for people.

We received positive feedback from a healthcare professional. They told us, “We work very well together with Prime Care, and I have no concerns to share. The operations manager is very approachable, and I would speak to them if I needed to.”

The registered manager had developed relationships in the local community including working closely with health professionals and local authority. However, people’s care plans did not contain information about involvement with other professionals.

The management and staff shared the same goal to provide positive outcomes for people. The operations manager understood improvements were needed. The management encouraged staff to discuss and share ideas for improvement and innovation. The operations manager was passionate about making improvements in the service and told us, “I want to keep staff involved throughout this process.” However, there was no formal record kept of lessons learned to improve future outcomes.

The organisation was clear about their vision and values and were aware they had more work to do to ensure all processes were communicated clearly and embedded to support learning and innovation. External relationships were being developed so care provision was joined up, working towards delivering a high quality and consistent service to people.