Carepoint Services Ltd (Prescott House)

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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. This is the first assessment for this unrated service. This key question has been rated good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 64 (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.People and external professionals felt the service was well-led, with leaders being visible and accountable.A person said, “I didn't want to come here in the first place, but my family were worried for me. I came to see Prescott House and I liked it. I'm really glad to live here. I would really recommend this place.” Leaders and staff shared a common understanding of what good care looked like, and how they should work together to achieve it. They did this successfully, which ensured consistently good outcomes for people. The registered manager said, “Our ethos is to provide the best possible care and ensure people are living their best lives and if they want to achieve something, that we can help them do it. Staff have discussions with people and if people want to do something, staff come tell us so we can help make it happen. For example, one person wanted to go to the Ardingly show. In the end, we organised a minibus and took 6 or 7 people there. They had a great time.

Leaders did not always have the skills and experience to lead effectively.This was the registered manager’s first role as a registered person. They were in the process of completing their manager’s qualification but said finding time to complete this was difficult. It was not always evident what support the registered manager had received from the provider to ensure they were effectively skilled and mentored to do the role.The registered manager knew the service, people and staff well.They led with openness and honesty. Staff told us leaders were approachable and supportive. Comments included, “Whether it is duty arrangements or any personal needs we have, [registered manager] sorts them out. They are good with all the clients and knows the clients very well. Before we tell [the registered manager] the problems, they already know what we are going to say”, “Dealing with the staff and residents is quite a big job but [registered manager] balances it well. They are forthright but fair and takes their job very seriously. The open door policy is good as well” and “[registered manager] is very kind and never makes us upset. They give advice in a different way and is always trying to make things right. [Registered manager] knows individually how I am, how each of the staff are and how we think. I really appreciate them.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.The registered manager welcomed feedback from people, relatives, staff and other professionals. They told us, “We have completed questionnaires with people. We are looking at new feedback forms for staff and people which are currently being revised but will be done yearly.” There was a whistleblowing policy in place and staff were aware of this and how to raise any concerns if they needed to. One staff said, “I am 100% confident that [registered manager] will deal with anything.” Staff told us they had attended team meetings. One said, “They talk about our mistakes and anything we need to do better; any changes to policies and anything we want to change here.”

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.Staff told us it was a good company to work for and they felt valued and respected. They said the service was flexible when they requested leave or needed to change their availability. Leaders valued staff’s different skills and worked well together. Service policies were in place for workforce equality and diversity and human rights and lone working. The registered manager said, “We are going to get equipment in place for staff who lone work. They just press a button, and it calls emergency services straight away.”

The provider did not always have clear systems of accountability or good governance.There had not always been effective systems in place to monitor when things went wrong. For example, we reviewed medicine audits and found there were recording errors. These had not been picked in local audits. Although correct follow up actions were taken in all accidents and incidents, it was unclear whether any trends or patterns were fully explored or whether any lessons were learned. The provider had not performed their own quality assurance checks to ensure processes were in place and effective. People had not been at risk of avoidable harm because leaders and staff knew them well. However, there should be processes in place to ensure effective oversight and governance. The provider and leaders had been open to feedback and taken immediate actions to make service improvements. However, this will take time to be addressed and embedded in the service.Leaders understood the duty of candour and were honest and open with us throughout the assessment process. Services are legally bound to inform the local authority and CQC about certain significant events that occur at their service. This legal obligation had been fulfilled.

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 registered manager and staff told us they worked in partnership with health and social care professionals to ensure good outcomes for people.One staff said, “We have a specialist nurse come in every day. They sometimes ask us to do some readings from the person’s electronic monitoring system when they are not there. We record it and then can discuss any concerns with them as they are experts in the field. We try to assist them as we can.” Partners shared positive feedback about staff and leaders. Comments included, “I have never had any reason for concern or had reason to doubt any of [the registered manager’s] decision making when I have been working with them” and “As an organisation, we have no concerns regarding the care and support our patients who live at the scheme receive.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation.They did not always have the necessary processes and systems in place to identify learning. For example, although people had been asked for feedback, it was not always evidenced how their views had been used to shape or drive improvements at the service. Leaders and staff had not had appraisal meetings to celebrate their strengths and successes, discuss areas for improvement or any future goals. Leaders were not aware of appraisals meetings and why they should have been held. The provider and leaders had been open to feedback and taken immediate actions to make service improvements. However, this will take time to be addressed and embedded in the service.Leaders reflected on areas of the service they could improve on. The registered manager said, “Everything’s been a learning curve. We are always making sure everybody is safe, and their needs are met. Our weakness is documenting it, evidencing what we have done.”