Premier Care Limited - Specialised Services

Updated 24 June 2023

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

The inspection team consisted of 1 inspector.

Service and service type

This service provides care and support to people living in a number of ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection. Inspection activity started on 22 April 2023 and ended on 18 May 2023. We visited the location’s office/service on 26 April and 2 May 2023.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 this information to plan our inspection.

During the inspection

During the inspection we visited and met with 3 people receiving a regulated activity. We also spoke with 2 other people who received minimal support from staff. We spoke with 9 members of staff, including 2 field managers, 4 support workers, the manager and a quality officer. We looked at documents including 3 people’s care plans, and 3 staff recruitment files, policies and audits.

The provider continued to submit electronic documents securely following the site visits to demonstrate compliance and to evidence improvements made. We contacted 3 health and social care professionals for feedback after the inspection.

Updated 24 June 2023

About the service

Premier Care Limited – Specialised Services is a domiciliary care agency, providing personal care to people living in their own homes. The service provides support to people who require care and supervision in relation to their mental health. The service was provided to people living in supported living arrangements.

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. At the time of this inspection 3 people were receiving personal care.

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

Risks to people's safety were assessed but these had not been reviewed and updated following any incidents or accidents. We have made a recommendation regarding this. Care plans informed staff about people’s preferences, likes and dislikes but required further review to ensure these were fully person-centred. Safe recruitment practices were followed, and suitable induction and ongoing training was in place for staff. Staff were signed up for external mental health training.

At the time of inspection, people were supported with the safe administration of medication. Recent improvements had been introduced and were being fully embedded into staff practice. There were sufficient staff to support people. Staff were safely recruited and felt well supported by the management team.

People received safe care and were protected against avoidable harm, abuse, neglect, and discrimination. People told us they were treated with kindness, compassion, and respect. People we spoke with felt they had developed good relationships with staff, some of whom had been providing support to them for several years. Staff encouraged people to maintain their independence and do as much for themselves as they were able to. People knew how to make a complaint. No end-of-life care was being delivered. People felt that staff understood their needs well.

There was no registered manager at the time of this inspection, but the provider was actively recruiting to this role. The provider understood their responsibilities and worked in an open and transparent way. Staff considered they were well supported by the managers of the service.

A service improvement plan was in place and the provider was working closely with commissioners of care. Reviews of care were ongoing to ensure people received appropriate care and support at the right time. Quality assurance systems were in place however, systems and processes in place had not identified the lack of regular review to risk assessments and support plans. These had not been updated following any incidents or accidents. Senior managers were working to implement changes needed to the service.

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.

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 requires improvement (published 18 May 2021) and there were breaches of regulation. 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 some improvements had been made, however the provider remains in breach of regulation.

Why we inspected

This inspection was prompted by a review of the information we held about this service. The provider has operated under the Cera brand since January 2022.

We have found evidence that the provider needs to make further improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Premier Care Limited - Specialised Services on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.