Your Priority 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 service. This key question has been rated inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of legal regulation in relation to governance.

This service scored 36 (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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, and engagement. They did not always understand the challenges and the needs of people and their communities.

Whilst the service had aims, objectives and values in place, these had not been consistently adhered to and throughout this inspection we found the registered manager failed to demonstrate they worked transparently and in collaboration with CQC. Furthermore, recommendations for improvement made by the local authority 6 months prior to our inspection had not been fully implemented. This demonstrated a poor culture to improvement and listening to others. Records also showed the service had failed to fully listen to staff feedback and act upon it.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied the culture and values of their workforce and organisation. Leaders did not have the skills, knowledge, experience and credibility to lead effectively, and they did not do so with integrity, openness and honesty.

We found the registered manager at the time of the inspection did not engage with the inspection process and that their knowledge around regulation, legislation and best practice was poor. For example, the registered manager had failed to follow CQC’s processes and guidance in relation to the delivery of the regulated activity and had to be reminded of CQC’s powers in relation to inspecting registered services when requested information was denied. Furthermore, the registered manager had failed to ensure care and support was being delivered in line with the provider’s own policies and procedures and best practice guidance.

Following our inspection, the provider informed us they had identified the need for a more experienced and skilled registered manager and had taken action to reemploy into this position.

People did not always feel they could speak up and that their voice would be heard. For example, staff gave us mixed opinions on how comfortable they felt in speaking with the registered manager and whether they felt they would be listened to. One staff member told us that despite raising issues and requiring support, the registered manager had failed to respond and listen to them.

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 raised no concerns in relation to being treated fairly and equitably and they had received training in equality and diversity.

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.

The provider had a quality assurance system in place, but this was of poor quality and had failed to identify and/or rectify the concerns found at this inspection or the ones identified by the Local Authority. Not all areas of the service were monitored for quality and to drive improvement and where quality monitoring audits were in place, these did not provide assurances they were robust and meaningful. Furthermore, regulatory requirements had not been met and the registered manager failed to demonstrate they had the required knowledge in relation to their regulatory responsibilities.

The provider did not understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not share information and learning with partners or collaborate for improvement.

Due to the provider’s lack of understanding around working with other stakeholders to ensure people received safe and effective care, recommendations they had made had not been fully implemented. These recommendations had been made to drive improvement yet the provider had failed to listen and act meaning widespread shortfalls remained at the time of this inspection. This placed the people who used the service at risk of receiving unsafe care or care that fell below the required and expected standards.

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.

There was no effective system in place to measure and evaluate the service to ensure its outcomes were consistently positive and safe and that all reasonable steps had been taken to mitigate risk. The service analysed little data and where analysis had taken place, this was of poor quality, and we saw little evidence of where it had been used to drive meaningful improvement. For example, staff feedback on suggestions for improvement had not been fully acted upon. We also saw that concerns raised on behalf of people who used the service had not been recorded and there was no evidence to show what action the provider had taken in response and to drive improvement as a result.