Prime Care Support Ltd

Updated 8 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by three inspectors, a medicines inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 9 May 2022 and ended on 30 May 2022. We visited the location’s office on 11 and 23 May 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We spoke with 17 people and 12 relatives about people’s experiences of care received. We also spoke with 11 members of staff, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed care and risk management plans for 23 people, recruitment files for six members of staff, complaints, compliments, safeguarding records, meeting minutes, multiple medication records, staffing rotas, incidents and accident recording, training records and staff supervision records. A variety of records relating to quality monitoring were reviewed as well as policies and procedures.

Updated 8 July 2022

About the service

Aylesbury Prime Care is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 133 people using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

At our last inspection we found many areas of the service were inadequate which placed people at risk of harm. We served three Warning Notices and issued five requirement notices for breaches of regulations. At this inspection, we found the service had improved and taken action to meet the Warning Notices and were no longer in breach of regulation.

People told us they felt safe with staff from the service. Staff had received safeguarding training and told us they would not hesitate to report any concerns. Any safeguarding concerns had been reported to the local authority and CQC had been notified. Staff had worked hard to ensure there were no missed care visits. Further work was needed to make sure visits were carried out on time, the provider was monitoring this. The provider monitored times and durations of care calls, data was collected, analysed and shared with the local authority weekly.

Risks to people’s safety had been identified and assessed. Management plans were in place which the provider had reviewed. Further improvement was needed to make some risk management plans more personalised. Since the last inspection the provider had moved all records onto an electronic care planning system which helped them keep oversight of risk management. Incidents and accidents were recorded, and the provider reviewed them to identify any themes. Any lessons learned were shared with staff to try and prevent reoccurrence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s whole needs were assessed and recorded in individual care plans. This gave staff guidance on a range of support people required to maintain independence living in their own home.

Medicines were managed safely. Staff had been trained to administer medicines and recorded all the medicines administered on people’s individual records. Staff liaised with various healthcare professionals when needed to make sure people’s health needs were met. Feedback we received from professionals about staff and the service was positive. They found staff to be responsive and knowledgeable about people’s needs.

People and relatives told us staff were kind and caring. People spoke to us about how they looked forward to their care workers visit. Overall people thought staff were trained but there was not the same confidence with newer workers. Staff had an induction when they started work which included all modules of the Care Certificate. Staff were able to shadow a more experienced worker and had their competence assessed. Staff received an ongoing programme of refresher training which was monitored and delivered in part by a training manager.

Recruitment was safe. Staff had the required pre-employment checks carried out. The provider had faced challenges recruiting new staff which they were trying to overcome. People told us there were times the service felt short of staff, which they said resulted in late visits. Whilst overall people did not feel rushed, they knew their care workers were busy. We shared feedback from people with the provider who was also carrying out quality surveys to gather people’s views.

There was a registered manager in post who had registered since the last inspection. Staff told us the registered manager was approachable and dealt with any concerns. People and relatives did not all know who the registered manager was. We shared this with the provider who told us they would send out some communication about the manager. Staff felt supported by the provider and many were long standing staff who all enjoyed their jobs. Staff had meetings and opportunities to share their views. The provider carried out spot checks regularly with staff to monitor quality and safety.

People were cared for by staff wearing suitable personal protective equipment. Staff tested for COVID-19 regularly and had received training on working safely. The provider made sure staff had all they needed to work safely during COVID-19.

Quality monitoring was taking place and the provider was regularly carrying out checks with people to monitor improvement since the last inspection. The provider had reflected on what had gone wrong at the last inspection and made many changes to carry out the improvement required. The provider worked in partnership with the local authority to meet people’s needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 22 June 2021) and there were eight breaches of regulation. We served the provider three Warning Notices following the inspection and five requirement notices. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 22 June 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.