Prestige Nursing Derby

Updated 17 May 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 was carried out by one inspector and two experts by experience who made calls to people prior to the inspection.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to younger people, some with physical difficulties, older adults and people living with dementia.

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:

We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that the registered manager would be available.

We made calls to the people who used the service on 10 April 2019. We visited the office location to see the registered manager and to review care records policies and procedures on 17 April and made calls to staff on 30 April 2019.

What we did:

We reviewed information we had received about the service since the last inspection. This included checking incidents the provider must notify us about, such as serious injuries and abuse. We sought feedback from the local authority and professionals who work with the service. The provider completed a Provider Information Return (PIR). 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 this information to plan our inspection.

During the inspection, we spoke with eight people who used the service and ten relatives. We also spoke with the provider, registered manager, a care co-coordinator and three care staff.

We reviewed a range of records. This included five people's care records and three staff recruitment files. We also viewed training records and records relating to the safety and management of the service.

After the inspection, we asked the registered manager to provide us with a range of additional information which was sent promptly following the inspection. We used this information to help form our judgements detailed within this report.

Updated 17 May 2019

About the service: Prestige Nursing Derby is a domiciliary care agency. It provides personal care to people living in their own homes. It currently provides a service to people with physical disabilities people with dementia and older adults. At the time of the inspection 50 people were receiving support with personal care.

People’s experience of using this service:

People were not consistently protected from the risk of harm. Poor staff consistency over visit times, missed calls and accuracy of staff visiting rotas left people at risk of harm. However, staff had been trained in safeguarding people and understood how to assess, monitor and manage their safety.

A range of risk assessments were completed, and preventative action was taken to reduce the risk of harm to people. People were supported with their medicines in a safe way. People’s nutritional needs were met, and they were supported with their health care needs when required. The service worked with other organisations to ensure that people received coordinated care and support.

People were protected by safe recruitment process which ensured staff were suitable to work in care services. There were enough staff to meet people's needs. All staff received training for their role and ongoing support and supervision to work effectively. Some staff received specialist training for people with complex needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider followed the principles of the Mental Capacity Act, 2005 (MCA) in planning and delivering people's support. People's consent was obtained before they were supported.

People were involved in their care as far as possible and care plans were regularly reviewed and updated as people’s needs changed. Where appropriate people’s relatives were involved in planning and reviewing people’s care.

Staff were provided with clear guidance to follow in the care plan which included information about people’s preferences, daily routines and diverse cultural needs. Staff had a good understanding of people's needs and preferences and worked flexibly to ensure people’s care needs were met. People’s relatives were happy with staff who provided their relations personal care needs and all had developed positive trusting relationships.

People and their relatives were encouraged to provide feedback about the service which was used to assess the quality of the service and to make any improvements. The provider had a process in place which ensured people could raise any complaints or concerns and people felt comfortable to do this should they need to. The provider had received many thank you cards and questionnaire feedback which included positive comments regarding the care staff provided.

The registered manager and provider were aware of their legal responsibilities and provided leadership and supported staff and people who used the service. The registered manager and staff team were committed to the provider’s vision and values of providing good quality, person centred care.

The provider’s quality assurance system to monitor and assess the quality of the service was used effectively to improve the service. Lessons were learnt when things went wrong, and improvements made to prevent re-occurrences. The provider worked in partnership with other agencies to meet people’s complex and diverse needs and people's health and well-being was continuously monitored at the service.

Rating at last inspection:

This was the first inspection of the service.

Why we inspected:

This was a planned first rating inspection. The location was registered on 29 June 2018.

Follow up:

We will continue to review information we receive about the service until the next scheduled inspection. If we receive any information of concern we may inspect sooner than scheduled.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk