We carried out this inspection on the 22 and 23 August 2017. The inspection was announced and was the first rated inspection for the service. We gave the service 24 hours’ notice of our inspection to make sure someone was in the office and arrangements could be made to speak to staff members.Prestige Nursing Agency provides trained nursing staff and health care assistants to hospitals, care homes and to individuals in their own homes. The agency provides services to children as well as adults and also nursing and personal care to people at the end of their lives. On the day of our inspection there were 68 people using the service.
The service had a registered manager in place. 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 who used the service told us they felt safe when being supported by staff members at Prestige Nursing. Staff had been trained in safeguarding adults and knew their responsibilities to report any concerns. There was also a whistle-blowing policy in place to protect staff who reported poor practice.
Risk assessments such as, mobility, pressure ulcers and nutrition were in place to keep people safe whilst staff members were providing support. These were reviewed on a regular basis to ensure they remained relevant and up to date.
Most staff we spoke with felt staffing levels within the service were adequate to meet the needs of people who used the service.
Records showed that robust recruitment processes were followed by the service when employing new members of staff. We saw references and identity checks were carried out as well as Disclosure and Barring Service checks.
All staff members we spoke with told us they had received training on infection control and knew their responsibilities in relation to personal protective equipment. Infection control policies and procedures were in place for staff to follow.
Staff were trained in medicines administration and supported people to take their medicines if it was a part of their care package. The service had two medicine policies and procedures in place, one for care staff and one for registered nurses, both of which were accessible.
We checked if the service was working within the principles of the Mental Capacity Act (MCA) 2005 and to ensure people were not being deprived of their liberty. The registered manager had not needed to apply to the court of protection for anyone using the service, however they understood their responsibilities to do so if they felt they were restricting anyone.
Staff received an induction when they commenced employment to become competent to work with vulnerable people. Staff were well trained and regularly supervised to feel confident within their roles.
All the people who used the service had been given a copy of the complaints policy and staff knew how to respond to any complaints they may receive. Records we looked at showed that any complaints had been managed in line with policies and procedures.
Robust quality assurance systems and processes were in place to ensure the quality of the service was regularly monitored.
We received positive feedback in relation to the approachability of the registered manager. Staff members told us they felt able to approach the registered manager with any concerns or issues they may have.
The registered manager was able to identify key achievements and challenges for the service. They were also able to demonstrate how they worked in partnership with other organisations in order to meet the needs of people who used the service.
We checked our records before the inspection and saw that accidents or incidents that CQC needed to be informed about had been notified to us by the registered manager.