Pacific Care Services Limited - Isle of Wight

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 leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider was in breach of legal regulation in relation to the governance of the service.

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 provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. The provider had a clear vision and values focused on delivering person-centred care that promoted independence and dignity. These were shared with staff during induction and monitored through supervision. The registered manager described the vision as “to provide care that is caring, compassionate, ethical, responsive to needs of diverse clients… we do this by individualising everybody, a holistic approach and multi-disciplinary working.” Staff echoed this understanding, saying, “To carry out our duty of care, be compassionate, attentive, communicate and be honest.” People and family members generally felt the service worked well, with a person saying, “It all works well for me,” and another commented, “I have to say I have had care for 10 years and this is the best company I have had.”

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively. The registered manager was supported by an office-based staff team. Each had a distinctive role and understood their individual responsibilities. Discussions showed the management team knew service users and staff individually. Leaders had appropriate knowledge and experience, including a qualified nurse as registered manager, but some governance tasks were missed which impacted oversight and placed people at risk of not always receiving safe care and treatment.

Leaders were approachable and supportive, and external professionals described them as responsive and willing to help. A social worker told us, “The registered manager and his team in the office are extremely approachable and always willing to help out, even with little notice.”

People felt they could speak up and that their voice would be heard. People and family members generally said they could raise concerns and that the office responded quickly during weekdays. For example, a relative told us, “If I have any issues I just say and they deal with it quickly,” and another said, “The office is easy to speak to and they are very helpful.” Some people mentioned completing feedback forms, although others said they had not been asked for feedback or surveys.

Most staff were aware of whistleblowing policies and felt able to raise concerns. A staff member said, “I feel able to raise concerns,” and another confirmed they were aware of the whistleblowing policy? Yes.” However, some staff reported that written safeguarding reports were discouraged, which could undermine transparency.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. The provider supported staff with personal needs, such as those requiring flexible hours. Staff told us they were treated fairly, and their human rights were upheld. The management team described supporting staff with extended leave and practical help, such as accommodation and transport for overseas workers.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Throughout the inspection and detailed in other sections of this report are areas for improvement which the provider had not identified through their governance procedures. This included risk assessments, recruitment information, information about staff cars, lack of travel time and inconsistent staff, mental capacity assessments, medicine management and complaints recording. Policies and procedures generally reflected best practice, but the recruitment policy was incorrect. Audits were described as monthly in governance plans, but these had not been occurring consistently, they included generalised statements and lacked numerical data to show improvements. The failure to ensure good governance and oversight of the service placed people at risk of not receiving safe care.

External professionals reported good communication but raised concerns about carers not always being fully briefed on client needs.

Providers are legally required to notify CQC about certain events which occur during the provision the regulated activity. CQC had not been notified of all significant events such as safeguarding concerns in respect of a person placing themselves at risk of harm due to use of unsuitable heater within their home.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. The provider worked well with external professionals and was open to advice. Positive feedback was received for example, a professional said, “Communication between myself and Pacific Care has been very good… they have consistently been open to my assessments and have followed the plans and advice I have put in place.” Another told us, “We have no concerns with Pacific Care.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. There was limited evidence of systematic learning and improvement. Some audits lacked detail whilst others and surveys had not been completed. Although positive examples of adapting care plans following external professional input were noted, there was no clear evidence of innovation beyond routine practice.