Premium Homecare Ltd

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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

We assessed all the quality statements within this key question. Our rating for this question remains requires improvement. We identified a breach of the legal regulations. There continued to be ineffective governance systems in place to review and improve care records and oversight of call scheduling. A new system had been introduced regarding call scheduling, but this was flawed and there were not effective systems in place regarding the governance of this system. A service improvement plan was in place. However this did not include timescales to ensure timely improvements were implemented. There was a shared direction and culture at the service, and staff felt well supported by their management team. The service was working well in partnership with the local authority.

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.

Staff told us there was a good culture within the team. The management team told us they had undertaken work since our last inspection to improve the culture at the service, and ensure staff and people felt able to speak openly and honestly.

The provider had renewed their vision and values. These focussed on; honesty, integrity, learn and reflect, dignity and respect, teamwork, and quality. The provider’s values were discussed during staff meetings.

Staff felt they had a good relationship with the management team, and felt there were capable and compassionate managers in place. They told us they felt able to approach their manager and speak openly. One staff member said, “I am most friendly with [staff member] and I can speak with her anytime.”

The management team had been slightly restructured since our last inspection to provide clearer management and oversight of the service. This also ensured clearer reporting procedures, and allocation of roles and responsibilities.

Staff told us they felt able to speak up and they were aware of the whistleblowing procedures in place. One staff member said, “Yes, we know the whistleblowing policy.”

A whistleblowing policy was in place.

Staff felt well supported in their role, and that their individual needs were supported. One staff member told us, “[The management team] will contact you and ask you if there are any questions. Any problem you have, they will support you. Anything you want you can share with them and it’s always confidential.”

A ‘good news’ Fridays, team lunches, and well-being champions had been introduced to support staff’s well-being and to foster a more open and supportive culture within the staff team.

Staff told us they felt there was a focus on quality and improvement. They said there were governance processes in place to check on their work to ensure it met people’s needs and was in line with the provider’s policies and procedures. A staff member said, “[The management team] will do spot checks. If there is any problem they will call us into the office.”

The new electronic care system had a built-in feature which tracked staff’s compliance with call times. This system would flag red so staff could easily track if a call was running late. However, this system was not being used effectively and did not include accurate data around call times. Call data showed that staff were recorded as being in 2 places at the same time and there was no travel time recorded between appointments. This data was not reliable and we found that there was not effective governance in place regarding call scheduling. There were also ineffective systems in place to review and improve the quality of care records. The registered manager told us all staff had received training on care planning. However, we found care records, particularly in regard to risk assessments and management plans, were inaccurate. The governance around these systems was ineffective in identifying and making improvements to the quality-of-care records. The registered manager had not adhered to all their registration requirements and had not notified us about specific events that occurred at the service.

We received mixed feedback about how the service worked in partnership with other services to meet peoples individual support needs. A family member said their relative received continuity in the care they received from other healthcare professionals. Whereas others said there was some discrepancy in support they received with social aspects of their care. We also received mixed feedback from people and their relatives about how involved in the service they were and whether they felt their views were sought and listened to. The registered manager told us they were working to improve on this and had recently sent out satisfaction surveys to gather people’s views.

Staff felt involved in and informed about service development. They felt listened to and provided with opportunities to share ideas. Comments from staff included, “[The management team] will contact you and ask you if they are any questions.” “They are always asking and we are having meetings. If you have problems or any concern they tell us.” “We have regular meetings and we raise our concerns. We come up with a good idea on how to manage things.” Staff told us they had good working relationships with the local authority and were working in partnership with them on some pilots they were running with local home care providers.

Partner agencies told us there was good joint working. They said the team at Premium Homecare were open and there was good communication, with a joint focus on improving practices.

Premium homecare had set up links with a local homeless charity to further support the local community.

Staff felt encouraged to improve practices at the service. They felt able to raise any concerns and these would be used to improve service delivery. Staff told us, “If I have any concerns, I let them know and they do something about it.” And “They always promote us to do better and encourage ourselves to do better.”

Improvements had been made since our last inspection around tracking staff’s compliance with training, supervision and spot checks and in relation to oversight of themes and trends identified through incident and accidents. Despite this, we found that improvements were still required, especially in relation to the quality of care records and call scheduling. A service improvement plan was in place. However, this plan did not include details of any deadlines or progress made against these plans and therefore we could not be assured that timely, effective improvements were being made.