Archived: Prime Time Recruitment - Walsall

We completed an inspection previously on 29 October 2013, where we found the provider was non-compliant with outcome 4: Care and welfare; outcome 13: Staffing and outcome 16: Assessing and monitoring the quality of service provision.

We found that improvements were needed. After the inspection, the provider sent us an action plan. This told us the action the provider would take and by what date.

At this inspection we checked whether required improvements had been made to issues identified at the last inspection. We completed a scheduled inspection and looked at other essential standards of care.

We found that the provider was compliant. Care and treatment was planned and delivered in a way intended to ensure people's safety and welfare. Staffing arrangements were in place to ensure that staff had the knowledge and skills to meet the needs of the children/young people whom they supported. The quality assurance system ensured that suitable arrangements were in place to provide assurance that children and young people received safe and appropriate care and support.

Below is a summary of what we found at this inspection. The summary is based on our observations during the inspection, speaking with people who used the service and their relatives, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

We found that up-to-date care plans and risk assessments were in place and staff understood how to support people safely. People we spoke with told us staff were competent and supported them in line with their needs.

People told us that they felt their rights and dignity were respected. They told us they were able to choose the staff they wanted to support them.

Systems were in place to make sure that the registered manager and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This reduces the risks to people and helps the service to continually improve.

Risk management plans were up-to-date and staff said they received updates when people's needs changed. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The registered manager completed the staff rotas, they told us and we saw they took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs are always met.

Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

We found that policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards were in place. At the time of our inspection no applications had been made. This meant that people would be safeguarded as required.

Is the service effective?

People's health and care needs were assessed with them and their families where required. People, their families and professionals were involved in making decisions about their plans of care. We saw that people's complex healthcare needs had been identified, with support networks in place to manage their needs appropriately. Parents and people who used the service told us that their care plans were up to date and reflected their current needs.

Is the service caring?

We spoke with the registered manager. They told us that six people used the service at the time of our inspection. They told us the majority of people were children or young adults. They told us that most people who used the service could not verbally communicate their needs to us.

We spoke with one person who used the service and three parents of people who used the service. We asked them for their opinions about the staff who supported them. Feedback from people was very positive, for example one person who used the service told us: 'I am happy with the service. I choose my carers and the activities I want to do'. One parent told us: 'This is a company that actually listens to people. They fulfil all care requirements and give us a choice of carers'.

We saw that people's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. One parent told us: 'We have a variety of carers and they all respect our culture'.

Is the service responsive?

People knew how to make a complaint if they were unhappy. Everybody we spoke to said that had not needed to make a complaint. They told us that minor issues were dealt with appropriately by the provider. We looked at examples of investigations which had been completed in line with the complaints policy. People could be assured that complaints are investigated and action taken as necessary by the provider.

The registered manager told us that people who used the service and their relatives were sent regular questionnaires to complete on the quality of the service and the staff who supported them. This was confirmed in the questionnaires that we looked at. All of the completed questionnaires had provided positive feedback to the provider about the quality of the service and staff performance.

The service worked well with other healthcare professionals and external agencies. We found that the provider had worked in a co-ordinated way with other external healthcare professionals to ensure that people's complex health care needs were met.

Is the service well-led?

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service. This helped to ensure that people received a good quality service at all times.

During the inspection we spoke with the senior care coordinator, care coordinator and one member of care staff. We telephoned and spoke with three care staff and three parents after our visit to the service.

At the time of our inspection the service was providing care and support to five children/ and young people who had complex health needs.

We saw that there were arrangements in place to gain consent from people who received care and support.

Parents told us that their child received the care they wanted and needed. We found that improvements were needed to ensure that care records accurately reflected the care that was required.

There were systems in place to people from the risk of infection.

We found that improvements were needed to ensure that all staff had the required skills and knowledge to safeguard children and young people and to ensure that they provided safe and appropriate care and support.

Improvements were needed to enable the provider to effectively assess and monitor the quality of the service provided to protect people against the risk of receiving inappropriate or unsafe care.

We observed that care plans provided more detail since our last inspection about the medicines people required care staff to assist them with. We saw that records which confirmed that staff had administered medicines were appropriately completed. This meant that people were protected against the unsafe and inappropriate administration of medicines.

The findings of this inspection were that the service had met the requirements of the warning notice and was compliant with the regulation we assessed.

During our visit we spoke with the manager about the care the agency provided. Following our visit we spoke with two relatives, a community nurse, a childrens' services commissioner and three care staff employed by the Prime Time Recruitment.

Parents we spoke with were positive about the care and support that staff provided. One parent said, "They have been brilliant from day one" another parent said "The staff are excellent they always have a smile on their face and I feel that they listen to us and take on X's views and respect them".

Since our previous inspection of the service some improvement had been made in relation to support provided by staff in relation to the management of people's medicines. However further improvement was needed to ensure that people received their medicines safely and as prescribed.

Appropriate arrangements were in place to safely recruit staff and protect people they would support. Appropriate systems were in place to raise concerns and protect people from abuse. People we spoke with told us that staff were reliable and could be trusted.

The service had appropriate systems in place to enable people to raise concerns and be confident that their concerns would be investigated and addressed.