The Care Quality Commission
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Archived: Precious Homes Limited

Overall: Good read more about inspection ratings

5-11 Green Lanes, London, N13 4TN (020) 8826 4343

Provided and run by:
Precious Homes Limited

Important: This service is now registered at a different address - see new profile

All Inspections

28 June 2017

During a routine inspection

This inspection took place on 28 June 2017 and was announced. Precious Homes Limited is a domiciliary care agency that provides staffing to three supported living projects in North London. People who use the service live in their own accommodation in self-contained flats. At the time of the inspection there were 18 people using the service. The service works with people with mental health, learning difficulties, drug and alcohol addiction.

At the last inspection on 25 February 2015 the home was rated 'Good'.

At this inspection we found the service remained 'Good'.

Risk assessments gave staff detailed guidance and ensured that risks were mitigated against in the least restrictive way. Risk assessments were reviewed and updated regularly.

Staff had received training on medicines administration and people were supported to take their medicines safely. Medicines were accurately recorded on medicine administration (MAR) sheets. People were supported to become independent with their medicines.

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.

There were regular reviews of people’s mental health and overall well-being. Staff knew how to refer people for both physical and mental health issues. People were involved in planning their own healthcare needs.

People were supported to shop and prepare for meals. People were provided with extra support around meals if this was necessary.

People said that they were treated with dignity and respect. Staff were able to give examples of how they ensured that they promoted dignity. People were encouraged to be as independent as possible.

Staff received regular supervision and appraisal that helped them identify areas for learning and development. Supervisions and appraisals were used as an opportunity for staff to improve care practices.

Audits were carried out across the service on a regular basis that looked at things like, medicines management, health and safety and the quality of care.

Surveys were completed with people who use the service and their relatives. Where issues or concerns were identified, the manager used this as an opportunity for change to improve care for people.

Further information is in the detailed findings below.

25 February 2015

During a routine inspection

We undertook an announced inspection on 25 February 2015 of Precious Homes Limited. We told the provider two days before our visit that we would be coming. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection. Three inspectors undertook the inspection.

This service is based in North London and is registered to provide personal care for people living in six supported living projects in North London. The service also provides care for people who live in their own accommodation outside of the supported living projects.

At our last inspection on 28 May 2013 the service met the regulations inspected.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

However, the manager registered with the CQC was not the manager running and operating the service at the time of our inspection. The manager registered with the CQC still worked within the organisation. The manager responsible for the running of the home had applied to the CQC to be the registered manager and was in the process of the application.

People who used the service told us they felt safe in the service and around care staff. The provider had taken steps and arrangements were in place to ensure people were protected from abuse, or the risk of abuse. Staff knew how to recognise and report any concerns or allegations of abuse. Several safeguarding concerns had been reported to the safeguarding team and to the CQC. The service had responded promptly, co-operated with the safeguarding team and taken appropriate action to deal with them.

People were cared for by staff who were supported to have the necessary knowledge and skills to carry out their roles and responsibilities. Staff had been carefully recruited and provided with an induction and training they needed to enable them to care effectively for people. Staff we spoke with had a good understanding of the needs of people. Staff spoke positively about their experiences working at the service and the support they received from the manager.

On the day of our inspection we saw that people who used the service were treated with kindness and compassion by care staff. People were being treated with respect and dignity and staff provided prompt assistance but also encouraged people to build and retain their independent living skills.

The manager and members of staff showed a good understanding of the Mental Capacity Act and issues relating to consent. CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person’s best interests. Appropriate policies and procedures in respect of DoLS were in place. People were not restricted from leaving the supported living accommodation.

Care support plans were person-centred, detailed and specific to each person and their needs. We saw that people’s care preferences were also reflected. People were consulted and activities reflected people’s individual interests, likes and dislikes. People were supported to follow their interests, take part in them and maintain links with the wider community.

The service had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. The service had a system in place to monitor and improve the quality of the service and this included regular audits. However, we noted that the service had not carried out a satisfaction survey in 2014.

28 May 2013

During a routine inspection

People we spoke with confirmed that staff communicated well with them and asked for their permission before any care or treatment took place. They told us that staff would always respect their wishes and preferences. One person told us “it’s really good. The staff are fine.” Another person commented “the staff are alright. They help me.”

People using the service had their own individual support plan. These plans gave information to staff about the care and treatment needs of people. People confirmed that they were involved in setting up these support plans. Staff had a good understanding of the needs of the people they supported. People who use the service told us they were satisfied with the support they received to take their medication. One person told us “I’m happy with the medication. I know what it’s for.”

Effective recruitment and selection processes were in place and appropriate checks were undertaken before staff began work.

People who use the service confirmed that the agency asked them how things were going and if they were happy with the care and support they received. One person told us “I have one to one meetings. I had a meeting recently.” Another person commented “they ask me if I’m alright.”

We saw that the provider carried out regular checks at the various supported living schemes including health and safety audits to make sure people were being supported in a safe environment.

10 October 2012

During a routine inspection

People who use the service told us that staff were kind and respected their privacy. They confirmed that staff treated them with care, respect and dignity. One person commented, “they do a fantastic job.”

People told us that they were offered choices in relation to how they wanted to be supported. They told us that they had regular one to one sessions with their key worker to talk about their care. One person told us they had been involved in recent staff interviews at their project.

They confirmed that staff assisted them when they needed support with their care and that staff were very helpful. One person commented, “they help me.”

People told us that they felt safe with the staff who supported them. They said they had no concerns or complaints about their care but would speak with their relatives, the person in charge or their key worker if they needed to.

People who use the service told us that they were happy with the staff who supported them.

One person commented, “they are all properly trained.”

Staff confirmed that they had regular supervision from their line manager. We saw written records of staff supervision which provided evidence that staff were being supported with issues regarding the management of challenging behaviour.

People were positive about the service and confirmed that the management and staff often asked them for their views about the quality of care they received and if they had any suggestions for improvements.

8 May 2012

During an inspection in response to concerns

Of the eight people using the service on the day of the inspection, two people were being provided with the regulated activity 'Personal care'. Staff supporting these two people were being supplied by Precious Homes Limited Domiciliary Care Agency.

These two people had been assessed as having high care needs and had communication difficulties. We were able to meet both these people and, from observations of their appearance and behaviour, they looked well cared for and they appeared comfortable with the staff who were supporting them.

Other people who use the service said they were happy with the staff that supported them. One person commented, 'Staff, on the whole, are very good'.

Care plans were not always being completed in sufficient detail which was putting people who use the service at risk.

People were also very positive about the newly appointed manager to the project. One person commented, 'She is a very good manager. She understands where we come from'.

Staff we spoke with said they generally enjoyed working at the project but did not always feel they were getting the training or support they needed to work safely and effectively in the challenging environment of the project.

All staff we spoke with said that things had got a lot better since the new manager was appointed.

17 February 2012

During an inspection in response to concerns

We visited the project in the South West on 17 February 2012, following concerns being raised about the way risks were assessed, medication was managed, incidents were reported and staff were trained and supervised. We also wanted to ensure people were being cared for through the domiciliary care agency which is based in North London.

We spoke with the deputy manager of the project, the behavioural specialist for Precious Homes Limited and the person who is to manage the project. We looked at some care records, including medication records, for one person who lived at the project. We did not speak with anyone who lived at the project on this visit.

Concerns were raised by the pharmacy team of the Care Quality Commission (CQC) about the medication policies and procedures for the project as these policies were not suited to a supportive living setting.

It has been agreed that representatives of Precious Homes Limited will discuss the registration of the project with the Commission.

13 October 2011

During an inspection looking at part of the service

Since our last inspection of this project policies and procedures regarding the management of medication had been reviewed and implemented so people who use the service were being protected from the risks associated with the unsafe use and management of medication.

We observed positive and supportive interactions between staff and people who use the service.

Staff we spoke with were enthusiastic about working at the project and had a good understanding about the needs of the people they supported.

Staff said they felt more supported by the management and confirmed that they received regular supervision. Staff were positive about the recent changes in the management and staffing structure at the project and said this had improved the quality of service provision.

22 August 2011

During an inspection looking at part of the service

We observed positive and supportive interactions between staff and people who use the service. We met with a number of people who were going out of the project with the support of staff. People who use the service appeared relaxed and were clearly enjoying the company of staff.

Staff we spoke with were generally very enthusiastic about working at the project and had a good understanding about the needs of the people they supported.

Staff said they generally felt supported by the management however we were informed that some concerns expressed by staff had not always been effectively identified and addressed.

The policies and procedures in relation to the management of medicines were not always being followed which was putting people who use the service at risk.

13 April 2011

During an inspection in response to concerns

People who use the service told us they were happy with the support they receive from staff.

One person commented, 'I like it here. They look after me well'.

Another person told us, 'They know what they are doing'.

We observed staff being respectful and friendly with people they were supporting.

People who use the service said they felt safe at the project. They confirmed that staff were respectful and kind. One person commented, 'I feel safe here. If I had any problems I would go and see the manager'.

People told us that they were assisted by staff to budget appropriately and that staff, 'Help with money'.

People who use the service told us they were satisfied with the way staff support them with their medication. One person commented, 'Staff support me with medication. They know what they are doing'.

People who use the service told us they felt there were enough staff on duty to meet their needs. A person commented, 'They help me so much'.

People we spoke to confirmed that there was always someone around to help them. One person commented, 'This place is never empty'.