Apex Prime Care - Basingstoke

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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

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.

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 service was in breach of legal regulation in relation governance due to internal quality and risk monitoring systems not identifying shortfalls in 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 based on transparency, equity, equality and human rights, diversity and inclusion, engagement and understanding the needs and challenges of people and their communities.

Most staff told us the service’s values were shared during induction and training. Staff understood the organisation’s aims and values, and leaders reinforced these throughout training. The manager told us the three core values were commit, connect and create, and explained that the service’s mission was to empower people to remain living at home for as long as possible.

However, although they understood the challenges and the needs of people; the care people received did not always reflect the service’s values and objectives as set out in their statement of purpose. People did not receive care that was always high-quality care, for example, people’s preferences not always being accounted for, their medicines were not managed safely and comprehensive information about their care were not always available.

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always demonstrate the skills, knowledge, experience or credibility needed to lead effectively, and they did not consistently act with integrity, openness or honesty.

We identified breaches of legal requirements and concerns relating to person‑centred care, safe care and treatment, good governance (including records), and failure to submit required notifications to CQC. Leaders had not identified or addressed all of these issues before our assessment, and further development was required.

The service had been without a registered manager for a prolonged period. As a result, some staff told us they felt unsupported, and people reported that communication had been poor and the quality of the service had declined. A new manager had recently been appointed and had begun their application to register with CQC. The manager was being supported by an area manager and a regional manager, all of whom we met during the inspection.

The provider sent surveys to people and their relatives to gather their feedback and used this information to make improvements to the service. The latest survey was at the end of last year and an action plan had been produced in December 2025 to show improvements made. This included making improvements on communication, staff continuity and office response times.

The provider had appropriate policies in place, including a Duty of Candour policy to ensure staff acted openly and transparently if people experienced harm in relation to their care or treatment.

Staff we spoke with said they felt confident speaking up on behalf of people. They told us they listened to people’s needs. Staff also demonstrated an understanding of how to raise concerns through the appropriate channels.

The service valued diversity within its workforce and worked towards creating an inclusive and fair culture by promoting equality and equity for staff. The provider had policies and procedures in place to support diversity and equality. One staff member told us, “I believe equality and diversity are promoted within the workforce. I work alongside colleagues from many different backgrounds, and I feel inclusion is present at carer level.”

The provider did not have clear responsibilities, roles or systems of accountability to support good governance. Leaders did not act on the best available information about risk, performance and outcomes.

The provider’s quality assurance processes had not identified all the concerns we found during this inspection. These included issues relating to medicines management, care risk planning and review, statutory notifications, person‑centred care, MCA and inconsistent staffing. Audits were not robust enough to identify or address shortfalls before they affected people’s care. Records showed notifications were also not always sent to CQC as required, which is part of the provider’s registration responsibilities.

An electronic medicines administration record (eMAR) system was in place, including functions for recording and managing time‑critical medicines, when‑required medicines, allergies and body maps. However, problems with staff rotas and rostering contributed to a number of alerts for missed doses, as staff were unable to access the system to complete records at the correct time. Medicine audits did not show these alerts had been promptly investigated to confirm whether medicines had been administered or missed for valid reasons. This meant accurate records were not consistently maintained and raised concerns about the robustness and effectiveness of the audit process.

Records were not always robust. Care plans did not always set out how staff should support people to reduce the risk of harm. This meant staff did not always have clear guidance on safe practice. For example, staff did not consistently review risks for people living with diabetes. While some records contained clear information, most lacked essential details needed to keep people safe. Records also showed that staff had not received training in diabetes. For some people living with dementia, documentation needed to be more robust and person‑centred.

Records in relation to staffing were not robust, training in certain areas were not in place and supervision, spot checks and appraisals were behind. Times of calls and preferences were not always accounted for and inconsistent staff at times made people anxious. The provider told us they had made improvements and were getting in extra staff from other locations to assist staff with supervisions and spot checks to ensure compliance.

The provider were aware of some of our concerns and had an action plan they were working through to ensure compliance.

The provider understood its duty to collaborate and work in partnership so that services operated seamlessly for people. Leaders shared information and learning with partner organisations and worked collaboratively to drive improvement.

The leadership team and staff worked effectively with health and social care professionals to meet people’s needs. Staff collaborated with relevant healthcare professionals when people’s health needs changed and made referrals to occupational therapists, community nurses and GPs when required.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. Although the service aimed to promote ongoing learning and improvement, we identified several concerns during the inspection, which are highlighted throughout this report. The provider was motivated to learn and improve, but the lack of effective risk and quality monitoring systems meant all areas for learning and improvement were not always identified. As a result, leaders were not always aware of shortfalls and could not consistently act promptly to drive improvement. While the provider was aware of some concerns before our inspection, we identified concerns that still required improvement or feedback from people to be considered in improving the service.