Princess Homecare

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 leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to 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.

This service scored 39 (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, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

At the last inspection, staff told us the culture of the organisation could be improved upon. At this inspection, a staff member said this had improved. They told us the provider had become better at listening and gaining advice so there was more honesty and transparency. They said they felt empowered to share their views and inform the provider if they did not agree with something. This culture however, needed to be further developed and embedded over time in line with the growth of the service and the staff team.

The provider told us they only supported 2 people, as the local authority had not offered them any new care packages. This was due to the provider’s previous inadequate rating. They said they intended to increase the number of people supported once this was lifted.

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.

At the last inspection, there was limited evidence to demonstrate high quality leadership or effective role modelling at the service. This was because there was a lack of formal systems, processes were not always followed, and some areas had lapsed without focus. 

At this inspection, some improvements had been made, but the provider was still not able to demonstrate effective leadership or clear knowledge of their management responsibilities. For example, the provider could not demonstrate a clear understanding of safeguarding, effective complaint management or the actions required to improve the service.

The provider told us they spoke to staff daily and had a formal staff supervision system. They said they supervised staff, and staff supervised them. Records showed details of the supervision sessions, but this did not ensure impartiality or an openness to raise any shortfalls. The provider had written a record of each supervision meeting despite not always being present at the sessions. They had then asked the supervisee to sign the document. The provider did not understand the risks associated with this practice.

People did not feel they could speak up and that their voice would be heard.

At the last inspection, there was a culture of staff not feeling they could speak up. This was because of loyalty and fear of the provider’s reaction. Although a staff member told us they felt confident they could raise a concern if needed, leaders could not demonstrate the importance of enabling staff to speak openly.

However, the provider did not demonstrate an open and transparent approach to speaking up. They continued to have a defensive approach and took any concern personally. This did not give assurance that people would be listened to, and their concern would be satisfactorily investigated or resolved.

The provider told us they could not understand why a staff member would have difficulties in talking to them. This showed a lack of understanding and self-reflection. A staff member suggested implementing a new system, whereby any new staff would approach them, and they would be the ‘go between’ to inform the provider. The provider did not see this was necessary, which demonstrated a lack of insight.

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.

At this inspection, staff had undertaken training in Equality, Diversity and Inclusion. However, other than a volunteer, there had not been any new staff. This did not enable the provider to demonstrate their commitment to ensuring 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, or share this securely with others when appropriate.

At the last inspection, quality auditing systems were poor and the provider’s quality assurance policy was not being followed. At this inspection, some improvement had been made but further work was required.

The provider had not taken responsibility to identify the improvements needed following the inadequate rating issued at the last inspection. The provider told us the volunteer would tell them what was needed as they were good at identifying what was wrong. However, the provider could not discuss the action plan the volunteer had developed. This did not demonstrate the provider was proactive or fulfilling their management responsibilities to drive improvement.

The provider showed a lack of understanding and responsibility in areas such as safeguarding and complaint management. They had also not followed safe recruitment practice. This did not reflect effective governance to ensure people were safe or received safe care.

A new financial transaction system had been introduced, but this process and its auditing were not effective. This was because the provider had not identified there were loose photographs of purchased shopping, which did not have associated receipts. This did not ensure a robust system, which minimised the risk of financial abuse.

The provider’s auditing systems had failed to identify the shortfalls regarding consent to care and treatment. This included assessments not being decision specific or clearly demonstrating how a decision had been reached. These shortfalls had not ensured decision making was in line with legislation or the provider’s own policy.

The provider’s quality assurance policy stated clients, relatives and representative’s views were gained by inviting them to complete a working feedback survey. This had not been undertaken, and the provider was not able to show us the format that was used. This did not ensure people’s views and that of others were gained and used to direct service development.

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

The provider told us they had held regular discussions with the local authority and had informed them of the improvements made. They said the local authority was happy with their progress, so they were hoping commissioning would be reinstated soon.

A health and social care professional told us in the spring of this year, they helped the provider with training, group supervision and auditing. They said the provider “Knew what they didn’t know” and would gain advice accordingly. However, they had not been asked for any support following the last inspection and the inadequate rating. This did not show the provider had made use of all available resources to help improve the service.

One health and social care professional told us the provider demonstrated a passion for the service and had a longstanding presence in the community. However, they had concerns that the service lacked leadership.

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.

The provider had made some improvements to the service. This included a new financial transaction system, additional staff training and improved care planning and medicine administration systems. However, there was further work to do to provide clear leadership and effective management of the service.

An action plan to address shortfalls identified at the last inspection had been devised, but the provider was unable to provide detail of this. There was a reliance on others to answer questions about the management of the service. This did not demonstrate the provider was confident in the action needed to ensure compliance with regulation. The action plan whilst detailed, did not show who would be responsible for the actions or give a date of compliance. This did not enable improvements to be monitored to ensure effective completion.