Prioritising People's Lives Ltd

Updated 15 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 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 Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 December 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in to assist us.

The inspection team consisted of two adult social care inspectors 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. The expert by experience contacted people and relatives by telephone to seek their views on the care and service provided.

Before the inspection we reviewed the information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales.

We contacted commissioners and other professionals who worked with the service to gain their views of the care provided by using Prioritising People's Lives Ltd.

The provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.

The registered manager sent us a list of people who used the service before our inspection. We contacted people via telephone and spoke with 14 people, some of whom were relatives of the person being cared for. We looked at three care plans, medicine records, five staff files, staff training records, and records associated with the provider's quality monitoring systems to see how the service operated.

During the inspection we spoke with the provider, registered manager, two care co-ordinators, two field care supervisors and four care staff.

Updated 15 January 2019

We inspected Prioritising People's Lives Ltd on 5 December 2018. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in to assist us.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people, people with learning and physical disabilities and people who have mental health conditions.

Not everyone using Prioritising People's Lives Ltd receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection there were 75 people who used the service and 63 people were in receipt of the regulated activity personal care.

At our last inspection in August 2017 we rated the service as requires improvement. This was because we found systems and processes for the administration of medicines was not always safe, risk assessments relating to health and safety for people were not always completed, care plans were not sufficiently detailed or updated in a timely manner and quality monitoring processes were ineffective. We asked the provider to make improvements. At this inspection in December 2018 we found the provider had acted and improvements had been made. We rated the service as good.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

People received safe care. Systems were in place to ensure people received their medicine safely and as prescribed. Staff had completed safeguarding training and they knew how to manage risks associated with people's care. Risk management plans provided staff with the information they needed to keep people as safe as possible.

Staff were recruited safely, and enough staff were employed to meet people's needs. People's care and support was provided by consistent workers at the times people expected for the correct length of time.

New staff received an induction when they started work at the service. People told us staff had the skills needed to support them effectively. Staff were supported with regular training, supervision and appraisal.

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. However, decision specific mental capacity assessments or best interest decisions were not formally recorded. We pointed this out to the registered manager who told us they would take immediate action to address this. After the inspection the registered manager sent us some mental capacity assessments as confirmation that this work had commenced.

Some people received support with their food and nutrition. Where this was the case their nutritional needs and preferences were recorded in their care records. The service worked with external professionals to maintain and promote people's health and wellbeing.

People and their relatives spoke positively about the care they received and told us staff treated people with dignity and respect. Staff helped people to maintain their independence. Policies and procedures were in place to arrange advocates for people should this be needed.

People told us they received personalised care based on their assessed needs and preferences. Care plans were reviewed regularly to ensure they reflected people’s current support needs and preferences. Procedures were in place to investigate and respond to complaints.

Staff spoke positively about the culture and values of the service and spoke positively about the registered manager. The registered manager and senior staff carried out quality assurance checks to monitor and improve standards at the service. The registered manager had informed CQC of significant events in a timely way by submitting the required notifications.