Posa Care Solutions Limited

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.

This is the first assessment for this newly registered service. This key question has been rated 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 record keeping and 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 culture of the service was caring and transparent. People and relatives were positive about the care and support they received from staff and the registered manager. The registered manager led by example and was passionate about providing good quality care.

The provider explained the challenges they had faced in developing a domiciliary care service but remained dedicated to overcoming obstacles and improving the service.

The registered manager and service manager were responsive to our feedback and stated they were dedicated to improving the records relating to people’s care and staffing records to assist and enable them to effectively manage the service and comply with regulatory requirements.

The provider had inclusive leaders at all levels; however, we found they did not fully understand the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation.

The registered manager had completed several training courses relating to the care sector, with the aim to help support and develop staff skills. However, their understanding of the regulatory requirements needed improvement to enable them to lead and monitor the service effectively.

The systems specified in the provider’s policies and procedures had not been fully implemented to ensure people received safe care from staff who had been suitably vetted and assessed as being competent in their role. For example, whilst some systems were in place to check staff skills and practices; these were not always recorded or the staff assessment checks lacked detail. Therefore, it would be difficult for the registered manager to determine whether staff were delivering care in line with the provider’s policies and if the actions needed to upskill staff had been effective.

The registered manager and service manager were genuinely caring and compassionate about the service and providing people with good quality and personalised care.

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

People, and their relatives felt able to speak up about any concerns and felt they would be listened to. People were happy with the care they received and had no concerns.

Staff said they felt comfortable raising concerns and felt supported by the management team. This was confirmed by a lead staff member who said actions were taken in response to any concerns raised.

Safeguarding and whistleblowing policies were in place to guide staff on how to speak up about safeguarding or other concerns.

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.

There was a diverse staffing team at Posa Care Solutions Ltd. Staff told us they were treated equally. The provider had policies and procedures in place to promote workforce equality, diversity and inclusion. Reasonable adjustments were made to enable staff to honour their religions.

The provider did not operate effective systems to record the registered managers monitoring of the service being provided.

We found there were gaps in the provider’s monitoring systems which could impact on the quality and safety of the care being delivered.

Through the provider’s governance systems, the registered manager had not identified shortfalls in people’s care and risk management plans, medicine records, staff recruitment and governance.

Effective and routine quality systems were not in place to ensure people’s care, risks and medicine records were accurate and complete. People’s care plans lacked detailed information to provide staff with key information on how to deliver safe and effective care. Systems to monitor and ensure accurate and contemporaneous records of care delivered to people were not effective.

Records relating to the safe management of medicines did not adhere to best practice guidance. People’s medicine records lacked detail of how people’s medicines should be managed and any shared responsibilities.

Effective systems to monitor staff recruitment checks had not been implemented to ensure safe recruitment was being managed in line with the regulations and the provider’s recruitment policy. Detailed records of the registered managers assessment and checks of staff practices and supervision and those completed during staff probation periods were not recorded.

Effective monitoring systems were not in place to ensure incidents were robustly scrutinised to determine whether significant incidents and safeguarding concerns should be notified to CQC.

Whilst people provided us with positive feedback, and the registered manager provided us with verbal assurances about their oversight of the service; there were limited records of their quality assurance checks with regards to the health and social care regulations and best practice guidance. This meant effective monitoring systems were not being used to identify and mitigate risks to people receiving personal care.

The registered manager assured us they had personal oversight of the quality of care being delivered to people and was able to respond to any concerns; however, this approach would not be effective if the service expanded.

The provider did not understand their duty to collaborate and work in partnership, so services worked seamlessly for people. There was limited recorded evidence that they shared information and learning with partners and collaborated for improvement.

The service worked effectively with other healthcare professionals and feedback from people’s relatives was positive. The registered manager explained how they worked with people’s families and their GPs and other health care professionals to provide care to ensure people’s needs were met. However, there were limited records of conversations with people and their relatives and referrals to professionals when concerns were identified about people’s health or support needs and any actions taken to resolve the identified issues.

The provider had some systems in place to share learning and drive improvement across the organisation. However, whilst we found individual incidents had been addressed with specific staff such as carrying out additional training and spot checks of staff, there was not always a shared learning approach across all the service.

The provider had not implemented an effective service improvement plan to assist the management team to prioritise and improve areas of the service based on assessments and gaps in evidence-based practices. Therefore, it was difficult to establish if the provider had a clear strategy with time scales and desired outcomes to drive improvement across the service.