Elite Support Providers Ltd

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• 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

We found management was not always open and honest with us as we found they were not using their registered office in line with their registration. We also found they were not providing all relevant information to people they provided care to as people had not been made away that they could choose their own care provider should they wish. Audits were carried out by management, but these did not always identify shortfalls or gaps. For example, a medicines audit had not highlighted the poor medicines record keeping and there was no audit of accidents and incidents to look for themes and trends. The lack good governance within the service was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Staff told us they felt supported by management and could approach them with any queries or concerns they had. Staff said they worked well together as a team and that everyone was working to the same goals of helping to ensure people received good care.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a lack of transparency from management. The registered manager told us documentation relating to people was held at their registered office in Camberley. However, we found this was not the case when we went to the offices. The registered manager then told us they had started using a different location as their office. The registered manager also told us that professionals and relatives were involved when moving a new person into the supported living setting. They said, “[Person’s name] dad comes every day. There was a meeting with everyone well before to discuss [person’s name] moving in.” However a professional told us this was not the case, saying, “I was not aware of any meeting” and a relative said, “Not consulted but they told me he was coming.” Staff told us they felt supported and had the opportunity to attend regular meetings as well as daily handovers. A staff member told us, “(We have a meeting) every month. They are worthwhile. We discuss any issues.” A second staff member said, “I have a lot of support. This is like family, there are lots of people working here. We get support from them. Whenever we need them (management) we can call them." Staff said there was a good culture within the staff team and they shared the same drive to support people well. A staff member said, “This is like a family. We get support from management and our peers.” Staff were helped through meetings and handovers. A staff member said, “Every morning we have a pre-briefing and we have a meeting on Fridays where we give a handover to the manager.”

There was no evidence of a vision being shared with staff by the registered manager or how the registered manager expected staff to display the values of the service. The registered manager and staff talked about people and told us they felt that over time once staff had got to know people well, people would receive a consistently good level of care and that they would support them to develop skills and live more independent lives. Although the service had generic policies around autism which stated that staff should be working in partnership with external professionals when appropriate, this did not happen in advance of one person moving into the service. As such processes around shared direction and care was not sufficiently robust.

Staff felt the service was well let and said they enjoyed the work they did. This was evident from the way they talked about people they were fond of them. Staff said, “[Registered manager] makes me feel valued”, “We are supported by our manager” and, “Good teamwork and everyone has the same mentality of wanting to help. No one comes in to do it just as a job.” All staff without exception said the registered manager was approachable and listened to them. They said, “[Registered manager] keeps asking if we can manage and check we are okay.” Staff also told us that their immediate line manager showed consideration for them as they ensured they had several days off between shifts. This enabled staff to take time out from their role and not feel overwhelmed.

Some people received the care they needed in line with their specific needs. A relative told us, “It’s good, very good. I would say [person’s name] is well looked after, but the management communication could improve. They could send emails to respond quicker and give more information.” Governance arrangements were in place to help ensure management had oversight of the day to day running of the service as well as staff's well-being. Staff meetings were held monthly and staff had daily handovers. This helped ensure that staff had the most up to date information about a person. Staff also told us they had a group on their mobile phones which they could use to exchange information. Although we read that staff had not always been given support when they had raised concerns about not feeling properly equipped to care for one person.

Staff felt management was approachable and they could go to them at any time if they did not understand anything.

Management held staff meetings regularly which gave staff the opportunity to discuss all aspects of the service. Staff also had the opportunity to discuss their role and any training requirements through their one-to-one sessions with their line manager. There was a complaints policy where people or relatives could raise complaints or concerns.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff were clear in their role and expectations. They told us they shared information with each other as well as their line manager to help ensure all staff were working consistently as they felt this helped improve people's care. They told us, "Every morning we have a pre-briefing and we have a meeting on Friday night and we give a handover with the manager."

Governance arrangements were in place and management carried out audits of the service to help ensure they were providing good care to people and that any shortfalls could be acted upon. However, audits did not always identify areas that needed addressing. For example, medicines audits had not identified the poor medicines records. The provider had not completed a robust pre-assessment prior to one person moving into the service and as such enable this person to have a good transition into supported living. There was a lack of management oversight in this instance as the location was not totally suitable for this person.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The registered manager told us they had developed a service improvement plan. This listed identified actions to improve the service as well as areas where good practice needed to be embedded. The registered manager recognised they were struggling to provide appropriate care for one person. They told us, “It’s not the right environment (supported living service), but they (the local authority) don’t have anything else. In the meantime, we are working together on this (to help improve his experience).” However, staff said, “We are pretty confident if we continue doing a good job, things will improve for [person’s name].” Following our inspection, we were made aware of numerous more incidents relating to this person which resulting in safeguarding concerns and referrals. Staff felt they worked well together which meant the service was improving. A staff member said, “I try to support who is working with me. Sometimes, we support each other to work in a certain way.” The registered manager had engaged the services of a consultant to help them work towards improving the service. The service improvement plan was regularly reviewed and updated by both the registered manager and consultant. Where accidents and incidents occurred, senior management carried out a root cause analysis and the incident was reviewed by the registered manager. Learning from these incidents was shared with all staff, although the registered manager did not carry out trends and themes analyses.