Archived: Prestige Nursing - Leeds

Prestige Nursing Leeds is a domiciliary care agency which is run by a national provider Prestige Nursing Limited. The agency provides personal care and support to people living in their own homes, including specialist care to people with physical or learning disabilities, dementia or people who require end of life care. The agency also provides nursing and care staff to hospitals, care homes and other providers of health and social care. Not everyone using Prestige Nursing Leeds 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 provider did not have a policy in place regarding the Accessible Information Standard. We have made a recommendation about this.

People continued to remain safe as staff knew how to recognise and respond to concerns of ill-treatment and abuse. The provider followed safe recruitment procedures when employing new staff members. When people needed it, they were safely supported with their medicines by trained and competent staff members.

The provider followed effective infection prevention and control guidance when supporting people in their own homes. The equipment that people used was maintained and kept in safe working order and the provider undertook safety checks with people at their home addresses.

People continued to receive care that was effective and personalised to their individual needs and preferences. People were supported by staff members who arrived when expected and who knew them well. They were assisted by a staff team who were well supported and had the skills and training to effectively assist people.

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible. Staff members were aware of current guidance which informed their practice and people's rights were protected by the staff who supported them.

People and their relatives, continued to be involved in developing their own care and support plans. When changes occurred in people's personal and medical circumstances, these plans were reviewed to reflect these changes. People and their relatives were encouraged to raise any concerns or complaints. The provider had systems in place to address any issues raised with them.

Further information is in the detailed findings below.

Prestige Nursing - Leeds is registered to provide personal care to people in their own home. They specialise in palliative care and care for people with complex care needs. At the time of the inspection the service provided care workers for a minimum of three hours although most visits were longer. Their main service delivery was a night sitting service but they also provided care during the day to some people. At the time of the inspection, the service had a registered manager. 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 told us the care provided was very good and they were complimentary about the care workers and management team. People’s care and support plans contained information about what was important to the person and how care should be delivered. Staff received training to make sure they could meet people’s complex and specialist needs. The service worked alongside other professionals and other agencies. They worked effectively with other agencies which ensured people’s needs were met.

People received consistent care and good systems were in place to ensure the same care workers visited. The service was reliable and was well managed. Staff were supervised and well supported by the management team who checked they were providing care appropriately and safely.

Staff knew how to keep people safe. They understood their responsibilities under safeguarding people from abuse procedures and were confident the management team would act swiftly and deal with any issues appropriately. Arrangements were in place for managing risk. Assessments were detailed and showed each area had been considered and where risk was identified measures were in place to remove or reduce risk.

People made decisions about their care and support. Information relating to a person’s capacity to make decisions was usually provided when they first started using the service. However, some information relating to capacity was not clear. The registered manager said they would review the support plans to make sure there was a clear up to date record.

Complaints were investigated and responded to appropriately. Systems were in place to help make sure people received safe quality care. A health professional told us, “They bend over backwards. People ask for staff from Prestige. They go out of their way and go the extra mile. They are reliable and do a sterling job.”

We spoke with several people who used the service and their relatives. People told us they were happy with the care and support they received. One person said, "The level of service we have had has been brilliant, it's worked really well." Another person said, "They are very, very good, I can't praise them enough." and "They go to a lot of trouble."

We saw records of medicines given to people were accurately recorded and signed for by staff. We were shown that all staff received training in the safe handling of medicines. This was followed by assessments to check they were competent to give medicines in a safe way.

We spoke with six members of staff. Staff told us they enjoyed working for the service and they felt adequately trained to carry out their roles. We saw there was a robust recruitment procedure in place at the service. We reviewed six staff files which contained CRB checks, identity checks, employment references, and full employment histories.

We found systems had been put in place to observe the quality of care provided, and to capture feedback from people who used the service or their representatives, and to check the standard of care was as expected.

People's care plans contained a good level of information that ensured their needs were being met. We spoke with two people and they told us they were happy with the care, treatment and support they received. One person told us, 'I am very happy with the care.' Another person told us, 'What ever I need they always help me, I am well looked after.'

People who used the service were protected against the risk of abuse. All staff had received training in abuse awareness and protecting vulnerable adults. There were information resources and training available to all staff in relation to safeguarding. The people we spoke with told us they felt safe with the staff.

People were treated by staff who were supported to deliver care safely and to an appropriate standard. Staff had a programme of on going training, supervision and appraisal.

There were quality monitoring programmes in place, which included people giving feedback about their care and support. This provided a good overview of the quality of the service's provided.