Progressive Support Services 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 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 did not always have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people.

There were instances in which the provider did not always work closely with others to maintain a shared direction and support continuous learning and improvement. For example, because care plans and risk assessments were not reviewed and updated following safety events in which people were exposed to risk and harm, opportunities for the provider to engage with people, relatives and staff, and strengthen service culture and direction was missed. A lack of consistent staff meetings further meant opportunities to share information and improve standards of care were missed by the provider. This meant people were at risk from a lack of provider contact to support engagement and learning.

The provider worked in consultation with some external services, such as healthcare professionals, local authorities and CQC.

Staff reported the provider was supportive. There were a complaints and equality and diversity policy in place. Staff received training in both these areas and most told us they were able to speak to leaders should they have concerns.

Leaders did not always demonstrate the skills and knowledge to lead aspects of the service effectively.

The provider had failed to identify and/or effectively address the concerns we have detailed within sections of this report, which included, care records not always providing information which reflected and mitigated people’s needs and risks, a lack of regular staff meetings and staff recruitment concerns. While there were areas in which leaders demonstrated effective leadership, such as staff feeling well supported, inconsistencies meant the service was not always consistently managed effectively at the time of this assessment, and there was an increased risk to people using the service.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The service had a whistleblowing policy in place; staff had an awareness of this and told us they would raise concerns with the provider and were confident these would be taken seriously and acted upon.

People and relatives told us they felt people received safe care from staff, knew how to report concerns and had confidence these would be taken seriously by leaders.

Where concerns had been raised, records showed these were responded to promptly, investigated and informed future practice.

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 registered manager promoted an open environment in which staff felt listened to and supported on a day-to-day basis.

Staff had completed equality and diversity training, which supported their understanding of inclusive practice and helped reduce the risk of discrimination, bullying or harassment.

Staff described a positive and supportive environment in which colleagues were treated fairly
and with respect. One staff member told us, “It’s good working here. Really good colleagues; a great place to work. We’re treated well.”

The provider told us they recognised the contribution staff provided to the service, and supported staff where they can, such as providing them with reasonable adjustments to them in their roles to support a positive work-life balance. This was supported by feedback from staff, with 1 staff member telling us the provider had adjusted their hours of work to suit changes in their personal life.
 

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

Effective systems and processes were not always in place to ensure care records contained accurate person-centred detail. Systems failed to highlight the concerns we found relating to staff recruitment. This meant governance systems were not always effective and exposed people to the risk of receiving care not aligned with their needs and wishes.

There were examples where effective systems were in place. For example, systems to ensure people transitioned safely into the service, and staff received robust inductions.

The provider did not always understand their duty to collaborate and work in partnership

While there were issues with internal communication and joined-up working, the provider demonstrated they understood their role and responsibility in ensuring they maintained appropriate communication with external partners. Safety events were reported to external partners, such as the local authority and CQC, where the provider was required to do so, and there was evidence staff liaised with external healthcare professionals, where required.

Staff supported people to integrate within their local communities.

The provider did not always focus on continuous learning and improvement across the service.

The provider had not identified and effectively taken action in areas of the service which required improvement. For example, the concerns we have identified during our inspection and detailed throughout this report. The provider did not always have a good awareness and understanding of audit processes and how these can be used to effectively identify concerns and mitigate risks to achieve continuous learning and improvement. This meant there were missed opportunities to learn and make improvements to the overall quality and safety of the service.