Background to this inspection
Updated
19 December 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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of two inspectors and a medicines inspector on day one of the inspection. On day two, one inspector and a medicines inspector visited people in the community and on day three, two inspectors returned to the agency office. An Expert by Experience conducted telephone calls to people who used the service and some relatives. 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
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 inspection was announced.
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 1 October 2019 and ended on 15 October 2019. We visited the office location on 1 October 2019 and 15 October 20219.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. 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 used all this information to plan our inspection.
During the inspection
We contacted eight people who used the service and two relatives by telephone to discuss their experience of the care provided. We visited three people in the community and spoke with a further three relatives. We spoke with seven members of staff including a director, area manager, registered manager, team leader and care workers. We reviewed a range of records. This included five people’s care files and multiple medication records. We looked at two staff files in relation to recruitment and supervision. A variety of records relating to the management of the service, including policies and procedures were also viewed.
After the inspection
After the inspection we continued to seek clarification from the provider to validate evidence found and reviewed further records in relation to the service.
Updated
19 December 2019
About the service
Premier Care – South Lancashire Branch (Premier Care) is a domiciliary care service. At the time of the inspection the service was providing personal care for 33 people.
Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People told us they felt safe using the services of Premier Care. One person said, “They’re (staff) really good and I trust them.” Another told us, “I feel very safe. They (staff) are very caring people.”
People were very complimentary about the registered manager of the service. One person told us, “She’s a lovely lady. The staff have a lovely boss; she’s grand. She’s a carer as well. When they have been short and the staff can’t get to someone she (registered manager) does it, so you know she cares, which is really good. When she came she talked to me about my package of care and I have to say it’s looking like a good package from Premier Care, so I’m very happy. The manager is really good and caring.”
Medicines were not being managed well. The Medicine Administration Records (MAR) were not being completed accurately and this put people at risk of harm.
The plans of care were not always person centred, as they failed to accurately reflect people’s assessed needs and how these were to be best met.
We made a recommendation in relation to assessing risk. However, infection control practices were robust. Systems were in place to ensure any safeguarding concerns were dealt with appropriately. Staff understood the actions to take in the event of a concern. Staff had been recruited safely and relevant training and supervision was undertaken.
We made a recommendation in relation to monitoring of the service, as some areas in need of improvement had not been identified through the auditing process and actions taken were not clear.
We made a recommendation in relation to mental capacity assessments, consent and best interest decision making. However, we observed that people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People’s needs were assessed and they received good care. People and their relatives were happy with the care provided by the staff team.
The service demonstrated partnership working. The staff team ensured effective liaison with relevant community professionals to support good care to people.
Complaints were well managed. People we spoke with raised no concerns about the service. Team meetings were being undertaken and positive feedback was seen about the service provided. A range of policies and guidance was available to support the care provided. The provider understood the operation and management of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was good (published 22 October 2018). Since this rating was awarded the registered provider of the service has changed its name. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection conducted due to the change of ownership.
At this inspection we have identified breaches in relation to the management of medicines and the planning of people’s care.
You can see what action we have asked the provider to take at the end of the full report.
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.