We carried out a review of the data available to us about Premier Care Services on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Premier Care Services, you can give feedback on this service.
Premier Care provides personal care to people living in their own homes in the community. It provides support to older people including those with physical disabilities and sensory impairments. At the time of the inspection 68 people were receiving personal care.
People’s experience of using this service:
Without exception, people and their relatives were very positive about their experiences of Premier Care. One person told us, “They understand me well. I am totally involved in deciding what they do and they always ask my consent. They are excellent.”
Systems continued to support people to stay safe and reduce the risks to them. People told us they felt safe and knew who to contact if they had any concerns and how to raise a complaint. Staff knew how to recognise signs of abuse and what action to take to keep people safe. There were enough staff to support people safely and the registered manager had safe recruitment procedures and processes in place.
People received their medicines safely and on time. Staff were trained in administering medicines. People knew what their medication was for and told us they felt reassured by the support with their medicines. People were protected by the prevention and control of infection. Staff wore gloves and aprons when supporting people.
People were supported to maintain their health and had support to access health care services when they needed to. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Without exception, people and relatives told us that staff were kind and compassionate and we observed friendly interactions between staff and people. Staff had a good understanding of the care and support needs of people and had developed positive relationships with them. People were supported to live as independently as possible and told us that their needs were met.
The service was a family run business and had a strong person-centred culture. Quality assurance systems were in place to monitor the service and drive improvements.
More information is in Detailed Findings below.
Rating at last inspection: Outstanding (report published on 1 December 2016). At this inspection there was not enough evidence to support a continued rating of outstanding in the key questions of Caring and Well-led.
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule for those services rated Good.
There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. We were supported on the inspection by the registered manager and the deputy manager.
Staff and management were committed to a supportive approach to caring and found ways to make sure that every person using the service were happy and comfortable. The service was a family run business and people and staff felt that they were part of the provider’s family. People were treated as individuals whose life and experiences mattered to the staff. One person said “The staff that come here are very friendly people, they are like family to me.” The manager and staff went out of their way to ensure that people and their relatives were comforted and looked after in a kind and compassionate manner and treated with dignity and respect. It was clear that staff understood people's needs and how to communicate with people. Staff had supported people to use information which helped them communicate more easily. People and relatives were at the centre of decision making about their care.
The service had a strong, visible person centred culture and is exceptional at helping people to express their views so they understand things from their points of view.
People, their relatives and staff told us the registered manager and all of the senior staff were caring, friendly and approachable. The registered manager took a personal interest in people and knew them well. The registered manager worked in partnership with people’s families and outside organisations to improve the care and support people received. The registered manager had systems in place which monitored health and safety and the quality of people’s support. The systems were responsive and had led to changes being made. The registered manager was proactive with regard to how people’s support could be improved.
People told us they felt safe using the service. Staff had received training in how to recognise and report abuse and were confident any allegations would be taken seriously and investigated to help ensure people were protected. There were sufficient staff at the service to provide care and support to people. Appropriate recruitment checks were undertaken before staff started work.
Staff understood the risks to people. Staff encouraged and supported people to lead their lives as independently as possible whilst ensuring they were kept safe. People’s medicines were managed in a safe way people supported to manage their own medicines.
People received support from staff that knew them really well, and had the knowledge and skills to meet their needs. People and their relatives spoke highly of the staff and the support provided. The staff made people feel that they mattered and that they were contributing to their own care.
People had detailed care plans in place which provided guidance for staff about how people liked their care provided. People and families were fully involved in making sure they planned care which suited their needs. People told us staff always respected the way they liked things done and respected their home. Staff received appropriate training and supervision to provide effective care to people.
The registered manager and staff had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. No-one receiving support was assessed as lacking capacity but staff members were aware of when someone may need to receive a mental capacity assessment and who to report this to.
Staff supported people’s nutritional and hydration needs and people were supported to access any health care they needed. Staff supported people to stay well and they followed the guidance given by health care professionals.
Complaints and concerns were taken seriously and used as an opportunity to improve the service.
The registered manager had informed the CQC of significant events. Records were accurate, well maintained and kept securely.
We found that suitable arrangements were in place for seeking consent of care from people using the service. People we spoke with confirmed that they were helped to make decisions and were able to have control over the time allocated to their care package. People told us that the service was very good, staff were flexible, cheerful, accommodating and they had good and responsive communication with the agency.
We found that people's care plans were comprehensive and staff had set instructions for delivering care tailored for the individual person. This was confirmed from the people we spoke with and we found that care plans available at the people's residence to be compatible with the one held at the agency. This meant that people were receiving the appropriate care and support as contracted.
We saw that there was a robust recruitment procedure in place for staff. We found that the agency had various quality monitoring tools in place and saw evidence of surveys carried out by the agency. The outcomes were positive and where applicable they responded to people's comments appropriately. We found that people were aware of the complaint procedure in place and were confident that their concerns would be heard and acted upon appropriately.
We found people's views and experiences were taken into account in the way in which they received care and treatment. People and their relatives told us they were supported to participate in their care.
Records showed that people were assessed prior to receiving a service. We found that care plans and risk assessments reflected people's assessed needs and wishes.
We found that staff had training appropriate to their role. Staff received regular supervision and an annual appraisal.
We saw that the provider had systems in place to ensure that people were safeguarded against the risk of abuse.
We found that the provider had an effective system for monitoring and assessing the quality of the service provided, which included the views and experiences of people and their representatives.