Premier Care (Midlands) Limited - Coventry

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

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 on 8 November 2017, we rated this key question good. At this assessment the rating has remained 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 71 (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 provider had a clearly defined vision and organisational values which were embedded within recruitment, training and day-to-day practice. Staff were clear on how these could be achieved and told us they made sure they promoted people’s independence by providing the best care possible. One staff member told us, “We are there to make sure people have the care they need and deserve”.

The registered manager told us their aim was to deliver safe, responsive and effective care which was well led. They did this by promoting equality, training for staff, reporting and recording, monitoring call logs, staff supervision and team meetings. One staff member told us, “I believe the management is fantastic, we will sit together and trust each other. We have been working together for a long time”. Another staff member said, I enjoy working in the service, it’s interesting, I feel a lot of joy helping people. I'm always excited because I know I am making a positive impact on their [people’s] life and give them a reason to live”.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The provider had a structured management team with clearly defined roles and responsibilities which included care co-ordinators, recruitment and retention staff, field care supervisors, training staff and a compliance function. This provided a framework for oversight and support across the service. This ensured operational responsibilities were shared and leaders were better able to manage risks and maintain service delivery.

Leaders shared a commitment to supporting staff and promoted inclusive practices through training and workforce initiatives. Staff reported leaders had good knowledge and were able to support. Staff spoke positively about leaders, describing them as visible, supportive and responsive. They said managers provided practical support, acted promptly on concerns and maintained effective oversight of the service. The registered manager also told us they felt supported by the provider.

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

The provider had systems in place to ensure transparency and openness. They encouraged staff to raise concerns through policies, staff feedback mechanisms, supervisions and regular team meetings. Staff felt confident to raise concerns and reported these were acted on promptly. This positive culture supported continuity of care and strong relationships between staff and the people using the service. This demonstrated that the organisation recognised the importance of listening to staff and promoting a culture where concerns could be shared.

The registered manager told us they operated an open-door policy with carers to ensure they could speak with any of the management team. One staff member told us, “Leaders encourage us to speak up”. Another staff member said, “I feel confident raising concerns because I know they will be listened to and addressed without judgement. When I have spoken up about issues, including training concerns or working practices, managers have always been supportive".

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 we spoke with told us there was a fair culture where staff were listened to. Staff gave examples and told us, “If I needed to talk to someone it would be looked into. When I started caring duties they reduced my hours as I found it too much and that wasn’t an issue. Have been flexible in the past”. “No concerns with treatment, all are treated fairly and equitably”.

Staff had been recruited from a range of diverse backgrounds that reflected the local community. We saw evidence in relation to workforce equality, diversity and inclusion during the assessment. The registered manager ensured people were safe in the office and in the field. They made sure people were comfortable and understood that bullying or any form of discrimination was not acceptable. Staff reported being happy in their role and were well supported. On staff member told us, “I have full support from the office, no problems. If I have any problems, I can speak to them. They understood my needs and what I could and couldn't do”.

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.

The provider had a range of robust audits in place to ensure management oversight of the service and care was being delivered safely and effectively. These audits were completed on a regular basis; the registered manager completed a monthly trend analysis which they used to support improvements. The service improvement plan reflected changes and improvements to the service however it lacked some detail. We identified some gaps and the provider acted promptly to update the missing information. Lessons learnt were shared in team meetings with office staff and carers.

During the assessment we identified the provider had failed to submit notifications to The Care Quality Commission (CQC) following incidents/accidents. Providers have a statutory duty to inform CQC when incidents/accidents occur which may put people at risk of harm or abuse. The provider demonstrated a willingness to learn and took prompt action to address these issues. And put systems in place to ensure this was completed moving forward.

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 provider understood the importance and benefits of collaborative working with other professionals. The registered manager gave examples of how they worked with the local authority social work and commissioning team to achieve positive outcomes for people. Staff worked with external health professionals and community health services to ensure people received effective care.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider had a good understanding and processes in place to ensure effective action was taken and learning happened when something went wrong. These mechanisms were used to continuously improve the service by reviewing, evaluating and completing an analysis of the trends identified through audits. The plan was used to track improvements which had been identified by the provider and their senior care team during weekly team meetings. This approach helped to ensure required improvements had been completed and any outstanding actions remained until the information was no longer required. The success of the provider’s approach was evidenced through the positive feedback we received from people and their relatives. For example, the service was making improvements to their responsiveness towards people when they needed consistency of carers or flexibility in care arrangements. One person told us, “They move the rota times, if I have to take [Name] to an appointment. If I phone the office, they are very helpful, they phone back when they say they will, I am grateful for the service, they help me not to worry about [Name]”.