First Prime Care Ltd

First Prime Care Ltd is a domiciliary care service providing personal care to adult people living in their own homes. The service can provide support to people with a learning disability, autistic people, people with mental health conditions and people with a physical disability. At the time of our inspection there were 51 people using the service, 27 of these people were receiving personal care support.

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 using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not provide a personal care service to anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support:

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 were consulted about their care needs and consented to their care plans and risk assessments. People’s independence was being promoted and respected. Risks to people were assessed and mitigated. Systems were in place to reduce the risks of abuse and to keep people safe from avoidable harm. Where people required support with their medicines, this was documented and provided.

People’s views about the service they received were valued and used to drive improvement. There was a complaints procedure in place and people’s concerns were investigated and resolved.

Right Care:

People’s person-centred care records provided guidance to staff in how to meet people’s individual needs and preferences. This included people’s dignity and privacy. There were enough staff to ensure people’s planned visits were undertaken. Staff were recruited safely.

People were cared for and supported by caring staff who were trained to meet their needs and preferences.

Right Culture:

There were systems in place to monitor and assess the care people received. This assisted the management team to identify shortfalls and address them. Lessons were learned from incidents and accidents to reduce them happening again.

The provider, management team and staff were committed to providing people with a caring and good quality service.

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 10 August 2018).

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for First Prime Care Ltd on our website at www.cqc.org.uk.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

At our last inspection of 20 and 28 October 2016, the service was rated good overall. The key questions for safe, effective, caring and responsive were rated good and the key question well-led was rated requires improvement. This was because improvements were needed in the service’s governance processes. At this inspection we found improvements had been made and is now rated good. The evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Improvements had been made in how the service was led. This included improvements in their governance systems to assess and monitor the service provided to people. The service had a quality assurance system and shortfalls were identified and addressed. As a result, the quality of the service continued to improve.

The service continued to provide people with a safe service. Risks to people continued to be managed, including risks from abuse and in their daily lives. The service had learned from incidents to drive improvement. There were enough care workers to cover people’s planned care visits. Recruitment of care workers was done safely. Where people required support with their medicines, this was done safely. The risks of cross infection were minimised.

The service continued to provide people with an effective service. People were supported by care workers who were trained and supported to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Systems were in place to support people with their dietary needs, if required. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

The service continued to provide a caring service. People had positive relationships with their care workers. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued.

The service continued to provide people with a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people at the end of their lives, where required. A complaints procedure was in place.

Further information is in the detailed findings below.

There was a registered manager in place who was also one of two directors of the provider company. 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.

The service quality monitoring and quality assurance processes were not embedded into the management of the service. They were not used to identify problems and drive improvement.

We have made a recommendation about quality assurance.

There were procedures and processes in place to ensure the safety of the people who used the service. Staff were provided with training and guidance in how to keep people safe and what they should do if they were concerned that a person was at risk or was being abused. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used

the service.

Care plans were person centred and reflected what was important to the person. They provided detailed information for care staff to enable them to provide care and support as the person wanted it. Staff received

People told us that they had good relationships with the staff that supported them. People and their relatives, where appropriate, were involved in making decisions about their care and support. People received care and support which was planned and delivered to meet their specific needs and people's consent was sought before they were provided with care and support. The service was up to date with the Mental Capacity Act 2015.

There were sufficient trained staff to meet the service commitments with the management team also providing hands on care. People were supported by staff that arrived on time and treated them with dignity and respect.

People using the service and their relatives knew what to do if they were unhappy with the service they received. They knew who to speak with if they had a concern and were confident that any concerns would be dealt with properly.