The Care Quality Commission (CQC) has carried out a well-led review of Elysium Healthcare focusing on how its leadership are working to ensure the delivery of safe and high-quality health and social care services.
The review was conducted between 12 April and 9 May 2022, as part of CQC’s risk-led schedule of independent health provider well-led assessments. Elysium was selected due to its inherent risk of caring for vulnerable people with complex care needs, concerns about it learning from incidents, patient safety and to understand how it addressed concerns about closed cultures.
Whilst the provider was performing well in some areas, others needed significant attention and engagement to improve. Elysium had a strategic direction for the future, but it was unclear how the plans would develop or what the outcomes for people using services would be. Some hospital services for people with a learning disability were operating with a model of care that no longer reflected current guidance such as CQC’s ‘Right support, right care, right culture’.
Work to include people using services, and staff, in designing the care delivery was at an early stage. Inspectors saw examples of advocacy services and community meetings being arranged at a local level, however, the activities needed further strengthening at an organisational level to empower people in making important and sustained improvements in the care provided.
Very small numbers of staff were using the Freedom to Speak Up Guardian service compared to the numbers of Elysium staff directly contacting CQC to raise concerns. Whilst the provider was aware, improvements were needed to ensure staff could raise concerns in confidence without fear of retribution. Elysium needed to better promote diversity and inclusion for staff and people using services; no work was done to understand the experiences of Black and Ethnic minority people and no networks to represent specific staff groups, who may be disadvantaged, had been established to provide them with a voice.
Head of Hospital Inspection, Jane Ray, said:
“When we reviewed Elysium Healthcare’s leadership, we found it was well established providing good continuity of services. The leadership had created an organisational culture based on integrity with proud and conscientious staff. Leaders recognised there were areas to improve on and work was underway, however, much was at an early stage.
“We saw Elysium developing the organisation’s operation ultimately to improve the care it provides. However, there was scope for further improvements particularly at the wider organisational level and more work needed to fully embed improvements and to understand the impact they would have across the provider’s services. There was opportunity to further strengthen the leadership by including representation of allied health professionals and an independent voice.
“It is vital that Elysium continues to improve its engagement with front-line staff and the people they care for, to ensure their voice is heard, so that concerns and risks are identified and addressed in a timely manner; to safeguard everyone and to drive improvements. Elysium’s quality improvement approach too, which was at an early stage, has room for engagement and improvement to better understand how they can stimulate innovation. We will keep Elysium Healthcare services under review and report on any inspection activity when appropriate.”
Action the provider MUST take to improve:
- The provider must further develop its strategy and clearly identify its strategic priorities. (Regulation 17: Good governance)
- The provider must ensure that a culture where staff are encouraged and supported to speak up is continuously promoted and that the systems and processes are in place to support staff to do this. (Regulation 17: Good governance)
- The provider must improve its oversight of diversity, equality and inclusion both within its staff group and service-user population and use this information to make tangible changes to how equality and inclusion are understood and promoted as part of the culture of the organisation. (Regulation 10: Dignity and respect)
- The provider must continue to strengthen its coproduction with people who use services and their families/carers. (Regulation 9: Person-centred care)
- The provider must ensure that ensure that systems and processes are in place so the use of the Mental Health Act and Mental Capacity Act has appropriate oversight through the governance structures. (Regulation 17: Good governance)
- The provider must continue to develop and embed its quality improvement approach and ensure this is widely embedded with the associated cultural shift. (Regulation 17: Good governance)