Prestige Nursing Liverpool

Updated 4 June 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:

The inspection team consisted of 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. In this inspection this included community-based services within adult social care.

Service and service type:

Prestige Nursing Liverpool is a domiciliary care agency. It provides personal care to people living in their own homes including older adults, younger disabled adults and children. The service is also registered to provide nursing care but was not actively doing so at the time of the inspection.

Not everyone using Prestige Nursing Liverpool receives 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.

The service had a manager who had been in post since January 2019 and was in the process of registering with the Care Quality Commission. This means that they will be legally responsible along with the provider for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

We gave the service four days' notice of the inspection because we wanted to consult with people prior to our visit. Inspection site visit activity started on 10 May 2019 and ended on 16 May 2019. We contacted people by telephone on 10 May and we visited the office location on 13, 14 and 16 May to speak to the manager and staff and to review care records and policies and procedures. We also visited people receiving support on 14 May.

What we did:

Prior to our inspection, we asked the provider to complete a Provider Information Return (PIR). Providers are required to complete this if requested and the document contains key information about their service, what they do well and improvements they plan to make.

We also reviewed statutory notifications that had been received and contacted the commissioners who help arrange and monitor the care of people supported by the service. We used this information to help us to plan how the inspection needs to be carried out.

During the inspection we spoke with two people who used the service and five relatives. We also spoke with the manager, the branch nurse, one care co-ordinator, one office-based staff and three care staff.

We looked at a range of documents and records related to people's care and the management of the service. We viewed four people's care and medication records, four staff recruitment, induction and training files and a selection of records and policies used to monitor the quality and safety of the service.

Following the inspection we received a copy of a revised medication care plan template in response to our feedback to the manager and branch nurse during the inspection.

Updated 4 June 2019

About the service: Prestige Nursing Liverpool is a domiciliary care agency. At the time of the inspection it was providing personal care to 15 people living in their own homes including older adults, younger disabled adults and children.

People’s experience of using this service:

Medicines were administered by trained and competent staff however we identified some shortfalls in the medication records and plans which were not identified in the provider’s audits or ongoing monitoring.

People received care and support from regular staff who were kind and caring. People's needs had been fully assessed before they received support from the service. Care plans held enough detail for staff to offer support that reflected people's individual needs and preferences. People's care needs were reviewed regularly. Staff understood the needs of the people they supported and had developed positive relationships.

Safe recruitment practices were in place and people were supported by staff that had undertaken a thorough induction process and training relevant to their roles. Enough staff were employed to meet the needs of the people using the service. Staff were supported through regular supervision and team meetings. Staff felt well supported by the current manager and office staff and worked well as a team.

Risks to people had been identified and staff had clear guidance available to them to support people and reduce the risk. People were protected from the risk of harm and abuse. Staff had received training and felt confident to raise any concerns they had.

Staff had access to personal protective equipment (PPE) to prevent and control the spread of infection.

People's independence was promoted and their right to privacy and dignity respected. People and their relatives spoke positively about the staff and management team. People told us their views were regularly sought regarding all areas of the service. People felt confident to raise any concerns they had.

The registered provider complied with the principles of the Mental Capacity Act (MCA) 2005. Staff understood and respected people's right to make their own decisions where possible and encouraged people to make decisions about the care they received. Consent had been sought before any care had been delivered in line with legal requirements.

People knew how to make a complaint and they were confident about raising concerns should they need to.

The manager was described as supportive and approachable. They worked in partnership with other agencies to ensure people received care and support that was consistent with their assessed needs.

Rating at last inspection: At the last inspection this service was rated good (13 December 2017).

Why we inspected: This was a planned inspection as the provider changed address.

Follow up: We will continue to monitor all intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner. For more details, please see the full report which is on the CQC website at www.cqc.org.uk