Priority Home Care

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 question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent.

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

This service scored 57 (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.

Priority Home Care aimed to deliver high-quality, personalised care that supported people to live safely and comfortably in their own homes for as long as possible. Staff told us that they believed people received person centred care and that they worked regularly with professionals.

Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

Leaders were visible within the service and lead by example to their staff team, demonstrating inclusive behaviours. However, management did not have additional training to that of other staff, for example, they had not completed any specific management training in safeguarding. Management did not attend any of their local support groups designed to provide support which would be beneficial to the service in order to access support and development in their roles. During the assessment the manager booked on to the level 5 Leader in Adult Care qualification. However, we received positive feedback from stakeholders, for example a professional told us “the registered manager is always clear about how they can support or if they can't support new patients. I can always get through to registered manager and what they say has always reflected what I have witnessed”.

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

The provider had a freedom to speak up policy in place. However, the provider had not always sought feedback from staff, for example, though a staff survey or an online anonymous questionnaire to enable their views to be expressed freely. The registered manager told us they would be sending out a staff survey. We received mixed feedback from staff about how they felt about being able to speak up. However, staff assured us people were safe from avoidable harm.

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.

Staff had completed equality and diversity training. We received mixed feedback from staff about the fair culture within the staff team. The registered manager assured us they would seek staff feedback.

The provider did not always have effective governance systems in place to identify and drive improvements at the service.

The provider did not have systems and processes in place to enable the provider to have oversight of safety and quality in the service. Staff informed management appropriately of incidents and management completed follow up actions. However, there was no system in place to enable management to have oversight of safeguarding, accidents, incidents and complaints. This meant the service was not able to identify any trends or themes and drive learning within the service. Monthly audits for these were implemented during our assessment. However, we have not been able to assess the effectiveness of this process.

Governance was not always reliable and effective. Systems and processes in place did not identify concerns we found during the inspection. The provider was streamlining electronic systems and navigating effective use of these. Due to a changeover of systems, not all staff file documents were available. The registered manager required a prompt to make safeguarding referrals during the inspection. Providers must notify CQC of any changes to their statement of purpose. The provider did not notify us of the change at the time.

The provider did not ensure staff had the required training and robust competency checks were not in place. Staff medication and moving and handling competency assessment were being completed, however, they required more detail so the provider could be assured that staff had completed training and developed skills to safely support people. These were developed during the assessment. Recently improvements were made around spot checks, supervisions and appraisals, however the registered manager told us that they planned to make these more detailed and more of an engaging and participant focused experience. During the assessment improvements were made to spot checks and supervisions. The provider did not have effective systems and processes in place to ensure oversight of policies being received and understood by staff. This placed people at risk of harm.

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.

We received positive feedback from professionals about how Priority Home Care work in partnership with them. A professional told us “they demonstrate a strong commitment to ensuring that all health-related needs are addressed promptly and effectively, collaborating with healthcare professionals to provide the best possible care.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system.

The provider had recently changed electronic systems, to use only 1 system, for care planning, medicines, rotas and staff files. This was to simplify systems and processes to be working more effectively. Regular staff meetings took place however, they did not evidence collective problem solving and/or reflection of improvements and learning from incidents. However, staff were informed when peoples needs had changed and that care plans had been updated. A professional told us, “the service actively seeks my feedback to ensure continuous improvements can be made. They demonstrate a commitment to quality and are always looking for ways to enhance their services based on constructive input”. We found no evidence the provider actively sought feedback from professionals, such as through surveys. Whilst we did identify shortfalls during this assessment, the provider was responsive to our findings and acted immediately on areas of improvement.