Background to this inspection
Updated
13 December 2023
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 Health and Social Care Act 2008.
Inspection team
The inspection team consisted of an inspector, a regulatory coordinator 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own home.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was announced. We gave the service a short period of notice of the inspection. This was because we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started on 20 November 2023 and ended on 29 November 2023 We visited the location’s office on 20 November 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 6 people, 8 relatives and 10 staff. This included the registered manager, the care manager, the deputy care manager, a care coordinator and care workers. We reviewed 8 people’s care records and 5 staff recruitment records. We reviewed records relating to the management of the service, complaints and incidents.
Updated
13 December 2023
About the service
Premium Homecare is a domiciliary care agency providing personal care to people in their own home. At the time of our inspection there were 107 people using the service. Not everyone who used the service received personal care. 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 the service and what we found:
The provider’s systems did not always effectively monitor the quality of care provided to drive improvements. At the time of our inspection there were not sufficient systems in place to ensure the registered manager had appropriate oversight of all areas of service delivery.
The electronic systems for care records and call scheduling was also not fit for purpose. We found complete, accurate and contemporaneous records were not maintained in regard to people’s care needs or risks to their health and welfare. Staff had not always appropriately assessed risks to people’s safety.
Whilst the registered manager was aware of and had started to make changes, at the time of our inspection we found people experienced late visits, insufficient planning for those people who required support from 2 care workers and insufficient travel time between calls.
Safe recruitment practices were not in place to ensure suitable and competent staff were employed.
People were happy with the support they received and had developed good relationships with their regular care worker. People felt safe and comfortable with their care worker. Systems were in place to safeguard people from avoidable harm. Adequate systems were in place for the administering and management of medicines. Good infection prevention and control procedures were in place. Individual incidents and complaints were managed appropriately. People, relatives and staff felt comfortable speaking with the registered manager and office staff. They felt any concerns raised were listened to and dealt with.
The registered manager was working well with the local authority and were making progress on their agreed action plan. The provider was in the process of purchasing a new electronic call monitoring and recording system which would enable them to have clearer monitoring and oversight of key information.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 6 August 2021)
Why we inspected
The inspection was prompted in part due to concerns received about poor timekeeping for visits, complaints management and risks relating to safeguarding matters. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
Enforcement
We have identified breaches in relation to safe care and treatment, staff recruitment and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow Up
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 continue to monitor information we receive about the service, which will help inform when we next inspect.