Elite 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 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 we rated this key requires improvement. At this assessment the rating has changed to 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 provider was in breach of legal regulation in relation to the governance and oversight of the service.

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 shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

The service did not demonstrate they had a clear strategy and vision detailing its aims and objectives. We found no evidence the management team shared a culture of collaboration, where people and staff are listened to and communicated with, to help promote learning and improvement. There was no effective governance framework in place and no action plan or improvement plan to manage improvements and identify areas of development. The management team did not demonstrate a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service. Most staff told us they did not feel supported in their role and felt they did not receive enough robust training to carry out their role effectively. We did not find there was a culture that focussed on equality and diversity, and we did not find reference to this within the service’s statement of purpose.

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.

The management team did not demonstrate their ability to provide robust oversight and strategic management of the service. We were not assured the management team had the experience, capacity, capability and integrity to ensure an organisational vision could be delivered and risks were well managed. We were not assured the manager running the day to day operations of the service had been suitably trained and supported to carry out the tasks involved, such as carrying out assessments of people’s care needs and assessing risks to their health, safety and wellbeing.

Information was not always readily available when we requested it and some of the information we requested on several occasions during the inspection was not produced at all. We made two safeguarding referrals; the concerns we raised should have already been identified by the management team and acted upon prior to our inspection. We were not assured any incidents were treated transparently and reported to the relevant authorities as necessary.

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

There was no policy or procedure in place for staff to have freedom to speak up and staff told us they were not aware of any speaking up procedure within the service. Staff had not had regular support meetings with the management team to encourage and enable them to raise any concerns they may have. Staff told us they had raised concerns on an ad-hoc basis; however, they had not received feedback and were not aware of what, if any, actions had been taken as a result of raising concerns. Staff told us they would speak up if concerned about a person; however, we saw no evidence any concerns raised had been investigated and acted upon.

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

We found no evidence effective systems or processes in place to support and develop an inclusive workforce. Staff did not receive regular supervision or annual appraisals to ensure ongoing support and development. There were no systems or initiatives in place to promote staff wellbeing and no staff reward schemes. The training matrix supplied to us by the management team indicated staff had received equality training; however, staff did not demonstrate an understanding of equality, and one staff member told us they had not done any training.

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.

Governance processes, such as audits, were not effective in checking the quality of care, ensuring people’s safety, protecting their rights, or ensuring staff had the necessary support and skills to meet people’s needs. The systems in place did not drive improvement, failed to identify the concerns highlighted during this inspection, and were not effective in monitoring quality or managing risk. Multiple concerns were identified across all several areas of the service including management of medicines, staff training, safe recruitment, staff supervision, daily recordings of care delivery, understanding of consent, care plans and individual risk management. We identified 4 breaches of legislation during this inspection, and these widespread shortfalls reflected a lack of effective oversight and accountability, increasing the risk of poor and unsafe care for people using the service.

The service’s business continuity plan was poor and did not contain information on what should happen in different emergency situations and how vulnerable people would continue to be supported safely during unexpected events impacting normal operations.

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.

We found no evidence of collaboration or partnership working to enable services to work seamlessly for people. We did not see where sharing of information, learning or good practice with partners had led to improvement within the service.

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 management team did not demonstrate a good understanding of continuous learning and how to make improvements at the service. Governance and oversight of the service was poor and concerns were not effectively addressed, managed and learned from. We saw no evidence of measuring outcomes and impact for people.

We were not assured people’s risks were competently assessed and monitored and learning from previous incidents, such as missed calls and medicines errors, was effectively and safely managed. We did not see evidence of a robust system in place to ensure the effective review of safety concerns and incidents, therefore, opportunities for learning and continuous improvement were missed. We were not assured all incidents were reported and addressed appropriately. This placed people at the risk of harm, and we were not assured people were always safe and receiving good quality, effective care.

We found no evidence meaningful feedback from people and staff had been routinely sought to enable their contributions to be used to develop and improve the service.