Parry Healthcare 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 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.

There was not always a shared direction and culture within the team. Whilst people were positive about the service, we found that staff were not always carrying out their work to the expected standard.

Staff were not consistently using the ECM system as expected to log their arrival and departure times during care visits. The provider did not take prompt action to ensure staff understood the importance of this issue or to address it effectively. Although the ECM system offers real-time monitoring capabilities, which would allow for daily oversight of staff activity, warning letters were only issued by the registered manager two weeks after—indicating that effective monitoring was not taking place.

People told us the service met their needs. One person commented, “I’m quite impressed with the service. They seem to know what they are doing.” A healthcare professional we contacted told us, “We had positive experience working with Parry Healthcare. We had positive feedback from the patients they worked with.” A staff member stated, “I like working with Parry Healthcare Ltd. They are concerned about the clients and want them to get good care.”

The provider did not ensure they had the capacity to run and manage the service effectively. They did not always embody the culture and values of their workforce and organisation.

The registered manager and owner was a qualified nurse. They demonstrated they understood their role and responsibilities. People, and their relatives worked with them effectively to meet their needs. One people told us, I’ve found [registered manager] and staff very helpful, for example when my care needed to fit with a health appointment, they made sure there was someone there to help and support me.” Staff told us they felt supported in their roles. One staff member commented, “The company is very good. Especially the registered manager. She is good. She is always very caring and supportive of us.”

However, the registered manager did not always have the capacity to deliver their role effectively. The registered manager was not always available to support the day-to-day operations of the service. They were responsible for managing two other domiciliary agencies located in different cities. At the time of our visit, there was no branch manager or office administrator in place to oversee or support the day-to-day operations in the Kent location. Due to the registered manager’s prior work commitments and personal medical appointments, we were unable to carry out our scheduled onsite visit at the originally planned time, as no staff would have been available at the office to assist us in their absence. When the visit did take place, the registered manager was present and received support from the branch manager based at the Wiltshire location. However, the service did not consistently provide the requested evidence within the agreed timeframe to support our inspection. For example, you did not provide the contact list for people, staff and the business continuity plan within the timescales.

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

Staff told us they knew how to raise their concerns to the registered manager and to relevant external organisations if the needed to. Staff told us they felt listened to and supported to discuss any matters bothering them. The provider had a whistleblowing policy and procedure. The registered manager told us they encouraged staff to raise their concerns to them or externally if they had they need to.

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 had received training in equality and diversity and the service had a diverse workforce. Staff told us they felt supported and treated fairly. Staff commented on how the provider had supported them to observe and follow their religious practices by being flexible on the rota. Some members of staff who had caring responsibilities also told us the provider enabled them to work flexibly which supported them in relation to childcare responsibilities.

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

The provider had failed to ensure there were effective systems for monitoring the quality of the service. We found several concerns with records and documentation in the service that the provider had not identified before our inspection. There were shortfalls in the management of medicines which the provider had failed to identify through their quality assurance process.There was a failure to maintain accurate, complete and contemporaneous records. Whilst we saw records of staff competency assessment, supervisions, spot checks and moving and handling competency assessments, we could not be sure when they were completed as they were not dated. Nor were they all signed by staff to show that they were part of the discussion and reflected their views and the actions agreed. Similarly, not all spot checks or supervisions were dated. The provider had not identified these shortfalls before our visit.

The provider had failed to effectively assess and monitor the quality of the service through effective auditing and checks. After our inspection, the provider informed us they would introduce a quarterly documentation audit protocol to prevent administrative oversights would.

There was no oversight of the electronic monitoring system (ECM) and prompt actions had not been taken to manage it effectively to reduce risk and improve the quality of the service delivered. The ECM data showed staff were not always logging in and out of care visits. The ECM data showed care calls were not scheduled and managed effectively to ensure people ’s needs were met. In some instances, staff were recorded as being present at two locations simultaneously. These discrepancies had not been identified by the provider before our visit. The provider sent us six warning letters they had issued to staff after our visit concerning their use of the ECM system.

There were policies and procedures to support the management of the service. However, medicine administration and management policies were not complied with. There were systems in place for auditing MARs, but this had not identified that people’s MAR did not contain all relevant details. After our inspection, the provider rectified this shortfall regarding MAR.

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 service worked in partnership with various organisations and agencies to meet people’s needs. People and their relatives confirmed that the provider supported them to liaise with other services and community facilities they needed.

The registered manager told us they worked closely with families, various health, and social care professionals to ensure people’s needs were met. Professionals we contacted also confirmed that staff and the registered manager worked closely and professionally with them.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not actively contribute to safe, effective practice and research.

We saw records of incidents, complaints and call monitoring maintained. The registered manager reviewed them and took actions to resolve them at the time. However, they had not always explored and put strategies in place to improve the service. For example, we found several entries on the care monitoring system which were reported as late calls. The provider reviewed them and made a note stating staff ‘forgot to sign in’ as the reason why the visits were showing as late without undertaking a thorough investigation. This issue occurred repeatedly over a two-week period, yet no prompt action was taken to address it—even though there had been a prior allegation that a staff member logged in and out of a care visit without actually providing care. The provider failed to learn from this incident and did not implement a robust system to monitor staff attendance and punctuality.

We were concerned that the provider was not focused on learning and improving the service provided.