Premier Nursing Limited

Updated 1 November 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This comprehensive inspection was carried out over two days by one inspector and an expert 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:

Premier Nursing Limited is a domiciliary care service, which provides personal care and support services for a range of people living in their own homes. The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection:

This was an announced inspection. We gave the service 48 hours’ notice of the inspection visit because it is small, and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available.

What we did before inspection:

Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection:

We spoke with six people who use the service, six relatives and seven members of staff including; the registered manager, CQC compliance administrator, care coordinator and four members of staff.

We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection:

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

We sought feedback for health and social care professionals about their experiences of the service.

Updated 1 November 2019

About the service:

Premier Nursing Limited provides personal care to people living in their own homes in the community. It provides support to older people and people living with dementia. At the time of the inspection 28 people were receiving personal care. This service provided both planned visits to people's homes and a live-in service.

People’s experience of using this service:

At a care visit observation, we identified that one person had a missed call, which resulted in medication not being given. Whilst the impact to the person was low, it is vital the provider ensures oversight of care calls.

People’s care documentation did not always record information about people’s preferences in relation to their end of life care wishes.

People told us they felt safe and knew who to contact if they had any concerns. Systems supported people to stay safe and reduce the risks to them. Staff knew how to recognise signs of abuse and what action to take to keep people safe. There was enough staff to support people safely and the registered manager had safe recruitment procedures and processes in place. A person told us, “I was already aware of their professionalism and knew I would feel safe with them.”

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.

People received kind and compassionate care. People and relatives told us staff treated them with kindness and we observed friendly interactions when attending a care visit. One person told us, “Before my wife became ill, I researched every care provider, Premier Ltd shone out above the rest as the most caring, professional, friendly and efficient organisation.”

People received person centred care that was responsive to their needs and people and relatives knew how to raise a complaint.

Quality assurance systems were in place to monitor the service and drive improvements.

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

Rating at last inspection: Requires Improvement (report published on 7 November 2018).

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care.

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.