Primera Assisted Living 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

The service was well-led. People were treated with respect and their dignity and equality characteristics were protected by staff and managers. There was a positive culture led by caring and compassionate managers. There were processes in place to monitor the service and ensure good quality person-centred care was delivered to people. Staff were aware of their responsibilities and their performance was assessed to ensure the service was maintained. Managers learned lessons when things wrong in the service such as following complaints and incidents. This helped with continuous improvement. The service scored 68 out of 100 in this area.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager understood the requirements under the duty of candour, to be open, honest and transparent. The management team told us they had carried out a lot of work to establish a service with a shared vision, strategy and culture. They demonstrated a good understanding of transparency, equality and human rights, diversity and inclusion. They acknowledged the challenges and the needs of people and communities in order to meet these. The registered manager was supported by senior staff and by the managing director to oversee the day to day running of the service. The registered manager said, "Dignity, respect, and kindness are embedded in the ethos of all all Primera Assisted Living staff towards themselves, each other, service users, family members, representatives, and professionals. We also want to make sure every member of staff has a sense of belonging which is vital as most of our care staff are lone workers and this can create loneliness. We promote an open and positive culture." The provider promoted a culture of openness and transparency which had been communicated to staff. There were regular meetings for staff and their views were listened to. Staff told us they felt valued, and their views were respected. One staff member told us, “It is a well managed service. We get a lot of support from the management and there is good communication and teamwork. There is a nice culture here."

The management team ensured policies reflected current guidance and best practice. They carried out welfare checks, spot checks and audits to make sure people were being provided support to the standards expected. The provider had informed us about significant events which occurred at the service within required timescales, as is their legal responsibility to do so.

Staff and leaders could demonstrate how the was compassionate and inclusive. They were respectful of people's needs, backgrounds and cultures and had the necessary skills, knowledge and experience. The registered manager told us they were open and honest with people and listened to their feedback. They promoted an ethos of openness, integrity and transparency in the workplace. Staff and leaders told us the registered manager had the necessary skills, knowledge, experience and credibility to lead effectively. A senior member of staff said, "[Registered manager] has worked really hard to make positive changes to the service. She is very involving and dedicated to the staff and service users." Staff were positive about the management team. A member of care staff said, "Yes the managers are caring and compassionate to everyone." The registered manager ensured staff were communicated with and included so that the care, treatment and support that was delivered embodied the culture and values of the organisation. There were regular meetings for staff to discuss important topics such as logging in procedures, incident protocols and recording care notes. Staff were able to provide their views in meetings. The registered manager said, "Staff meetings are an ideal opportunity to embrace an open and positive culture, which has seen recent transformations with new members within the office team. It is a safe space for staff to speak freely, with support, compassion and a sense of humour when appropriate."

Processes were in place for the service to uphold equal opportunities in accordance with the Equality Act 2010. People received care that was person-centred and their care plans included information such as their preferences, interests and protected characteristics, such as age, disability, race, religion and sexual orientation. People's communication needs were assessed and respected. For example, if people's first language was not English, the service had developed communication cards, which included everyday tasks and routines in the form of a picture, such as a bathroom or clothes. This helped people and staff communicate with and understand one another. People's consent to care was confirmed and recorded. Staff told us they made sure people were given choices and encouraged to be as independent as possible. This was aligned to promoting inclusivity and compassion towards people, respecting them as individuals. The registered manager also understood their responsibilities under the Duty of Candour to be open, honest and to do so with integrity. Staff and managers followed the provider's ethos, values and standards to ensure quality care was provided to people. People told us the service was generally well managed. A relative said, "They treat people with respect, they listen and try their best to help you. The manager said to let them know if there is any problems and I said I’m so happy with [family member's] carers.”

Staff told us they had opportunities to speak up if they had any concerns about the service. Staff felt confident they would be listened to and treated fairly if they raised concerns. A staff member said, “The manager is good and listens to us.” Staff had platforms to share concerns or queries, such as in individual supervision meetings and wider staff meetings. People and relatives could contact the service at any time to speak with the registered manager or other senior staff. Records showed the registered manager contacted people and relatives to listen to concerns they raised and carried out investigations following complaints. They took action to address issues. Relatives knew how to make complaints and felt there was a culture of openness and honesty. A relative said, “This time round the service is more professional. They e-mail me, get back to me. I think it’s new management. I’ve been introduced, [registered manager] has been round and I’ve put a name to a face." There was a policy for whistleblowing. This meant there were processes for staff to follow should they wish to speak with external agencies such as the local authority, the CQC or the police, if they were unable to report concerns about people’s safety to the provider or if concerns were not acted upon by the provider. Staff told us they knew of the service's whistleblowing policies and how they could report concerns about the service outside of the management team.

Staff told us they were supported with their specific needs and the culture of the service promoted equality and equity for people. Staff told us the provider had created an inclusive environment. The registered manager said, “All our workforce have knowledge and understanding of people using our service with reference to the 9 protected characteristics as stated in the Equality Act 2010, in addition to the values of our organisation. Dignity, respect, and kindness are embedded in the ethos of Primera." Recruitment, development and disciplinary processes were in place of staff to ensure they did not experience disadvantages or based on staff's specific protected equality characteristics and they were treated fairly and equally. The provider managed the service as an inclusive workplace where staff were treated and supported as individuals. Staff told us they were supported to maintain a balanced working life and working patterns to help with their specific needs. For example if they had family care commitments or religious needs. Staff told us they were able to take breaks and their health and wellbeing was taken seriously by managers. The registered manager said, "All our staff are given days off and sufficient rest in accordance with the Working Time Directive. This could be 1 day per week or 2 consecutive days over a two-week period."

At our last inspection the provider did not always ensure quality assurance processes were robust enough to assess and monitor risks within the service. This was a breach of regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17. The management team had an effective oversight of the service. The service had systems and processes in place to ensure people received a good standard of care. There were more robust governance systems in place to monitor risk, safety, staff performance and outcomes. For example audits of call times, care plans, medicines and infection control systems took place. Staff completed daily notes using their devices which gave an overview of the care people had received. They also captured any changes in people's health and risks. Notifications were submitted to external agencies such as the CQC and the Local Authority as required. Leaders and staff understood their individual roles and responsibilities and what was expected of them. Staff had confidence in the registered manager. They felt supported and valued. Staff comments about the governance included, "There are a lot of checks to make sure we are doing our jobs and people get good care." Staff had access to technology to complete electronic records. People were provided information on how to complain about the service or report abuse. There were systems and processes to protect people's confidential information from being misused. The registered manager and managing director confirmed they analysed all feedback people provided and identified any patterns or trends to make changes. We saw evidence of this. Records showed complaints and concerns were fully documented and addressed.

The provider worked with professionals and partners such as the local authority and local integrated care board (ICB). Health and social care professionals provided feedback to us that was positive about the improvements made in the service. One professional said, “The service has reassured us that they are working on areas to improve their rating. We have no concerns." The provider was working in partnership with people’s relatives, health professionals and local authority departments to ensure people were supported appropriately. The registered manager understood the importance of collaborating and working in partnership. However, they had experienced some frustration with processes following the referral of people to the service after hospital discharges and safeguarding concerns raised by the service. This could potentially impact the safety of people and we noted the provider was making efforts to ensure communication and information sharing was as effective as possible.

The registered manager told us continuous learning, innovation and improvement was important to the development of the service to ensure the continued safe care of people. There were regular meetings for staff and their views were encouraged. Staff told us they felt valued, and their views were respected. Meetings were used to identify areas for improvement in staff performance. Staff told us there was a culture of learning in the service to encourage staff to always try and improve. A staff member said, "Our meetings are good and we go over areas that we need to do better. For example recording and reporting or logging our calls."

The management team spent time working with staff to identify areas that may need improvement. The registered manager ensured they always kept up to date with changing guidance. The management team ensured staff were adhering to current guidance and best practice by continuous assessments of their competency and performance. They also ensured policies had been updated to reflect these changes. However, further improvement was required to ensure all staff follow the the correct procedures for logging their calls and making sure 'double up' calls were carried out safely and appropriately. We noted the new call monitoring system would help identify issues such as this more readily for action to be taken. The management team had recently introduced a 'handover' process for office staff to enable the sharing of knowledge, concerns and any updates for people and front line staff. This allowed leaders to use this information when working in the community when visiting people or checking on staff. The registered manager also told us they had revisited the importance of staff completing incident and accident forms appropriately as the information assisted the service to identify risk factors and trends so people could be kept safe. For example, it helped to identify a person who could be at risk of fire in their home. The provider together with the person and the local fire service ensured risks were assessed and eliminated. This showed how the provider could demonstrate positive learning, innovation and partnership working.