Profad Care Agency 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.

At our last assessment we rated this key question Inadequate. At this assessment the rating has changed to Requires Improvement.

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.

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

This service scored 61 (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.

Staff spoke mainly positive about working at the service and told us they felt supported. Regular staff meetings were held at team and management levels, providing opportunities to raise concerns. Leaders had a clear vision for the service and shared this with staff through meetings and routine communication.

Improvements had been made since the last inspection: however, governance processes were not fully embedded. Audits did not consistently identify key issues, including medication concerns and best- interest decision- making, and the statement of purpose lacked required information regarding the registered manager's oversight for example. Audit and quality assurance systems required further strengthening to ensure effective day -to -day oversight.

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 management team were passionate and proud of the service they provided. They demonstrated ambition to improve and further develop the service improve and provide a high- quality service without impacting on the quality care people received.

There were systems in place to assess, monitor and improve the quality and safety of the service and the registered manager demonstrated a proactive approach to addressing concerns identified during the assessment, however some systems were still being embedded.

Staff told us they were supported by the management team and confident in the leadership's knowledge and skills.

It was evident from conversations with staff, and feedback from people and their relatives there was positive working relations with people and families.

People and their relatives described positive relationships with management and spoke of their approachability, with one family member stating, “I wouldn’t manage without them. They support me and between us all we are managing (relatives)support” Another said, "Overall we are very happy with them. Issues are always fixed. (staff member) is always on the phone.

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

The service had appropriate policies in place such as freedom to speak up/whistleblowing.

Staff told us they knew how to speak up if they had any concerns, including anonymously, and said they mainly felt supported to do so.

Staff demonstrated awareness of the whistleblowing process and had access to the relevant policies.

People and their relatives told us they were encouraged to share their views and provide feedback about the service.

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.

The provider had appropriate policies and procedures to promote equality, diversity and inclusion within the workforce. These recognised people's protected characteristics and outlined measures to prevent discrimination and to support staff appropriately. Staff had received equality, diversity and inclusion training, supporting inclusive and fair working practice.

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 some governance systems in place, and had made improvements from previous inspections, including audits of medicines, spot checks and action plans. However, these systems were not yet robust or embedded enough to effectively monitor and improve the quality of the service. Audits did not consistently identify significant shortfalls, including medicine administration timings, absence of signature specimen sheets and lack of best-interest decisions. While staff notes being task -orientated had been identified, there was no care plan audit in place, which would have highlighted many of the concerns found during this assessment. Audits had failed to identify omissions in the statement of purpose. Although actions and improvements were discussed with the registered manager and plans were in place, governance arrangements had not been effective in driving sustained quality assurance across the service.

Despite concerns about poor oversight and governance of the service., people’s experience was positive, and we found no evidence that the concerns we had identified had impacted on the quality of people’s care.

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 service demonstrated effective partnership working with GPs, social services and nurse practitioners to support people's care. External professionals provided positive feedback, describing the service as well organised and well led. People's views were sought through surveys, which were generally positive. The registered manager and staff understood the value of multi-disciplinary working and collaboratively with other professionals to ensure people received consistent and timely care.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Feedback was gathered from people and their relatives through review meetings and home visits, and staff were encouraged to share feedback during meetings and supervisions. Policies were in place and accessible to staff. The registered manager demonstrated commitment to continuous improvement, responding positively and proactively to findings during the assessment. Whilst a range of audits were undertaken, these required further development and to become fully embedded to consistently drive effective learning and improvements. Although some learning had occurred since previous inspections, systems and processes still had not been sufficiently effective in monitoring and improving the safety and quality of the service.