Elite Support Providers Ltd

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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained 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 to good governance.
 

This service scored 54 (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 documented values and organisational objectives which promoted person-centred care, dignity, equality, inclusion and safeguarding. However, the provider did not demonstrate during the assessment how their vision and values framework was consistently communicated, embedded and monitored across the workforce.
Where staff were not always delivering care in line with people's assessed needs, we did not see sufficient evidence demonstrating how this had been identified and addressed to assure us that staff consistently worked in line with the provider's stated values and expectations.

Leaders did not always demonstrate the level of capability required to maintain effective oversight of the service. They did not consistently recognise risks or shortfalls in practice, which meant some concerns were only identified during assessment rather than through leadership monitoring.

During the assessment, we identified some concerns regarding the information and records available to demonstrate compliance with the provider's systems and processes. As a result, we could not be assured the provider had consistently embedded a culture of openness, transparency and continuous learning and improvement. For example, we identified discrepancies within some training records, which reduced our assurance that training information was accurate and reliable.

Most staff told us the registered manager was visible. However, this was not consistently experienced for all staff and feedback was mixed, with some staff reporting limited visibility or engagement.

The provider had policies in place relating to complaints, equality and diversity to support staff and people. We found these policies were reviewed. The registered manager also told us how they felt supported. They said, “A lot of my support comes from staff, we work together, even the people we support. They support us. they help me in a lot of ways.”
 

The provider fostered a positive culture where staff felt able to speak up and raise concerns.

There was a freedom to speak up policy in place at the time of the assessment. Staff told us they felt able to speak up with concerns to management. Staff told us management were responsive and supportive and readily available if they reached out. Staff told us they had regular supervisions and they could speak up and raise any concerns during this.
The registered manager told us they supported staff to encourage a culture of openness. They said, “Our structure is always welcoming. It’s about being available for people. Addressing things that are worrying people rather than it escalating and forming cliques.”
 

The provider promoted equality, diversity and inclusion through policies, training and workforce support.

The provider promoted an inclusive working environment. Policies reflected equality and diversity principles. The training matrix demonstrated all staff received training in the Equality Act 2010. The registered manager told us, “We have a policy we adhere to; we have procedures around making sure the 9 protected characteristics are followed. A lot of this is about educating the workforce, people’s needs, understanding different races, religions, embracing the diversity rather than making it a cause for a split.”
 

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

The provider established governance systems and processes to assess, monitor and improve the quality and safety of the services provided. However, these systems did not consistently provide effective assurance across all areas assessed, nor negate the concerns identified regarding medicines oversight, Mental Capacity Act processes, staff training oversight, risk management and governance effectiveness at the time of assessment. The quality assurance systems had failed to identify and address all of the concerns we found during this assessment.

The provider did not regularly monitor and review the use of restraint and restrictive practices. Decisions made on behalf of people were not always recorded or evidenced as being in line with the Mental Capacity Act 2005 and associated Codes of Practice. For example, we found several decisions were being made in the same capacity assessment and best interest decision meetings. These decisions were not regularly reviewed to ensure they remained the least restrictive option.

The provider did not have effective oversight and good governance of people’s medicines management. The registered manager did not ensure all staff followed the assessed needs and guidance for people’s risk management to ensure they were not put at risk of avoidable harm.The provider had not maintained effective oversight of all staff learning and development and required training to ensure people’s needs could be safely met.
 

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people.

We found some evidence of partnership working for people. However, this was not always timely, clearly documented or regularly reviewed to ensure all relevant agencies remained informed and involved. For example, although 1 person had been assessed by SaLT, the provider did not demonstrate they always ensured staff followed the recommendations of the assessment. Despite differing views on the person’s required level of thickener, the provider did not ensure they raised these concerns with SaLT immediately. As a result, the provider could not always demonstrate how collaborative working contributed to achieving positive outcomes for people
 

The provider had systems intended to support learning and improvement, including audits, supervision, peer reflection, staff and family feedback, handovers and action planning.

We found examples where staff reflected on practice and where improvement actions had been identified. However, these arrangements were not consistently effective across the service. Audits and oversight had not always identified or resolved the gaps and discrepancies we found in care planning, risk management and record keeping. This meant opportunities for learning and improvement were not always recognised, acted upon or sustained.

We also found continued breaches of regulations from the previous assessment. The provider had not demonstrated that learning had resulted in consistent and sustainable improvement across the service.