Princess 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

We reviewed 7 quality statements for this key question and identified one breach of the legal regulations. Oversight and management of the service was poor and systems such as quality auditing processes were not effective. Processes and best practice were out of date and the provider could not demonstrate improvement from learning. Feedback about the culture, and the provider’s capability in the service, was mixed. However, leaders were fully involved in the service on a daily basis and were passionate about 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.

Leaders and staff shared the same direction of wanting to provide an excellent standard of care and personalised service to people. However, staff told us the culture of the service could be improved upon. Leaders told they wanted to expand the service, but said it depended on the regulators and the outcome of recent assessments. These had identified widespread concerns, and Wiltshire Council temporarily put all new care packages on hold. This did not enable the growth leaders wanted.

The Statement of Purpose contained limited information about the service’s direction and culture and records did not show discussions had been held with staff. There was further detail on the provider’s website although some areas were not up to date and required review.

Staff told us leaders were very passionate about the service. However, there were variable views about their capabilities and wellbeing, within an ever-changing social care climate. Leaders clearly displayed their passion for the service and said they had devoted the last 27 years to it, without days off or holidays. They said they regularly provided people’s support and worked alongside staff when needed so were very visible.

There was limited evidence to demonstrate high quality leadership or effective role modelling at the service. This was because there was a lack of formal systems, processes were not always followed, and some areas had lapsed without focus. This meant adequate safeguards were not in place and people were at risk of poor practice and harm.

Not all staff were confident in raising a concern or poor practice. This was because of loyalty but also for fear of the provider’s reaction and the way things had been dealt with in the past. This showed a poor culture and did not ensure people received a safe service. Leaders told us they were Freedom to Speak up ambassadors and encouraged people to raise any concerns. They said they had a Freedom to Speak up policy on the wall in the office and all staff knew it was there. However, these processes were not being applied in practice due to the reluctance of some to speak up.

Records showed there had not been any concerns or complaints since January 2022. This did not show an open and honest culture, which empowered people to share their views.

The staff team was not diverse, but leaders acknowledged this. They said they respected people’s protected characteristics and would take these into account when next recruiting staff. This included age, ethnicity, faith, gender, and sexuality. There were no other plans to enhance diversity.

Processes were not effective in ensuring unbiased practice. This was because leaders and some staff had not completed up to date Equality and Diversity training. There was also no monitoring as identified within the provider’s Equality and Diversity policy. This was needed to ensure the requirements of the Equalities Act 2010 were met and particularly applied to race relations, sex discrimination, disability discrimination, religion and belief and sexual orientation.

There was not a registered manager in post as required in accordance with the provider’s registration. Leaders told us they were in the process of re-registering to become the registered manager, alongside a member of staff. They previously held the role but relinquished this in 2017. Leaders told us they completed checks to ensure they met the regulations, but records did not always evidence these. Staff told us they were very aware of the responsibilities of their role and what was needed. However, this was through their own experience, rather than formal systems of the service.

Quality auditing systems were poor and the provider’s quality assurance policy was not being followed. This was because there was not a structured process in place or a monthly review of areas such as accidents and incidents, staff training, supervision, and people’s medicines. This meant leaders could not be assured all areas of the service were working well. The lack of auditing also meant the shortfalls found during this assessment had not been identified. This put people at risk of poor practice and harm.

Relatives told us they were kept informed of any changes in their family member’s health and wellbeing. They said the relevant professionals were contacted as needed.

Leaders told us they had built good relationships with other professionals such as the GP, community nurses and chiropodist. They said they liaised with the pharmacy regarding any queries with people’s prescriptions and took any samples to the local surgery as requested. They said they also assisted local providers by transporting their staff to and from care homes and facilitating other provider’s domiciliary care visits during the winter storms.

Health and social care professionals provided us with very mixed feedback about the service. Some shortfalls were raised, which generally related to the lack of formal systems in place. Professionals said this was problematic, and meant the service was not performing at a good standard. One health and social care professional told us they no longer used the service because of this.

The Local Authority had identified widespread concerns in the service and had set leaders an action plan to address all shortfalls. The service had been placed on red alert, which meant no new care packages were being commissioned until improvements had been made. Leaders told us they had addressed all actions required of them. However, further shortfalls were identified during this assessment.

Feedback from staff and leaders was conflicting. Leaders told us they liked to learn and always welcomed any advice or new ideas, to ensure they were meeting regulation. They said they had a particular training document which kept them up to date with information. However, staff feedback was that the service did not always keep up to date with best and changing practice. This put people at risk of poor or unsafe support.

Processes were poor and not effective. There was little evidence of systems being developed and innovation within the service. For example, up to date guidance for the safe management of medicines was not being followed, people’s capacity had not always been properly assessed and inadequate systems were in place for managing people’s shopping. This was alongside a lapse in staff training, no formal supervision of staff and poor-quality auditing systems. Such shortfalls showed there had not been any learning and out of date practice was being followed. This put people at risk of harm. Leaders were in the process of moving their systems to digital, so were beginning to familiarise themselves with this moving forward.