Premier Care Services Limited

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

At our last assessment, we rated this key question as good. At this assessment, the rating remains the same.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care plans did not always include individualised information and person-centred instructions for staff. People’s care plans were primarily task orientated, for example, they did not always include specific information for staff regarding a person’s history, likes and dislikes, social/leisure interests and preferences.

However, staff knew people well and made sure people, and their families were at the centre of their care and support choices. The service decided in partnership with people and their families how to respond to any changes in people’s needs.

One person’s relative told us, “I feel the care is personalised to [mum/dad] as [member of staff] knows [him/her] so well. They understand [his/her] dementia”. Another person’s relative said, “[He/she] only has a male carer in the morning. We asked for this to protect [his/her] dignity, which they consider when providing care”.

One other person’s relative told us, “They [staff] are consistent. We asked for the carers [he/she] has specifically. It all works really well”. Another person’s relative also said, “The majority of their time is spent with [him/her] as a companion”.

The provider understood the diverse health and care needs of people, so care was joined-up, flexible and supported choice. The provider worked in a transparent, collaborative, flexible and open way to make sure care and support were joined up for people. Staff could identify when there was a gap in a person’s care, and the provider could take appropriate action. This included when people may have been eligible to receive more care or support.

People received the full care and support that had been funded and the provider worked with commissioners to ensure continuity of care was managed.

The registered manager said, “If a client is self-funding but needs more care, I discuss it with the client and refer to social services to see what social services can support with. Normally by the time we get to the point that a client needs more support, the client usually knows because I discuss it with them as we go along”. The registered manager also told us, “When I do a needs assessment I match carers to the client. I always try make sure clients have the same pattern of carers. If a member of staff goes on holiday I communicate with the client to let them know a different or second carer will be coming in. I also get staff to shadow each other in case a member of staff needs to cover in an emergency”. 

One person told us, “I’m happy with everything. I feel they are worth the money they charge me”. A person’s relative said, “We have increased [his/her] care to two carers to keep [him/her] safe”.

The provider did not always follow the 5 principles of the Accessible Information Standard (AIS). The AIS is an NHS policy requiring organisations to provide information in formats that meet people’s communication needs. Organisations must ask about and record people’s communication needs, highlight those needs in records, share the information where necessary and ensure the person receives information in their preferred format.

People’s records did not always include information about their individual communication needs or instructions for staff about people’s preferred methods of communication.

However, staff knew people well and communicated with them in ways they could understand. One person said, “[Member of staff] is on time every day and calls ahead if running a little late, either by phone or by text”. The registered manager told us, “We have used technology to communicate with a client and to recognise their body language, for example”.

The provider made it easy for people to share feedback or raise complaints about their care and support. They involved people in decisions about their care and told them what had changed as a result.

The provider had a ‘Complaints, Suggestions and Compliments’ policy and procedures in place and people and their relatives knew how to raise concerns or make a complaint. People, their relatives and staff felt comfortable to raise concerns or make a complaint and were confident the provider would listen to them, respect their views and take appropriate action.

People, their relatives and staff were able to contact the office or the provider at any time to raise concerns. The provider also used surveys to obtain feedback from people, their relatives and staff. As well as complaints, the provider and staff had received formal compliments from people and their relatives.

There was a system and process in place to log complaints, investigate them and record the outcomes.

However, complaints were not audited and the learning from complaints and surveys was not always recorded or made clear. This meant it was not always possible for the provider to identify themes and put improvement plans in place to mitigate the risk of similar concerns or complaints.

A person’s relative told us, “We did make a complaint as only one carer turned up and had to wait for the other one. They listened. The office staff are great. They answer the phone quickly. We know the manager and she knows us. We think they are so good we recommended them to someone who uses them now and is very pleased with the care they provide”. Another person’s relative said, “I haven’t made a complaint. Any niggles or concerns, I have told the manager. I have confidence in her”.

One other person’s relative told us, “It’s really easy to contact the office. They are approachable and flexible with regards to [his/her] care. I can cancel them [care calls] easily if I need to. They took three attempts to get the right carer for [him/her]. I would recommend them”. Another person’s relative also said, “I’ve never had to make a complaint, but I would if I needed to”.

A member of staff told us, “We have team meetings, and they are recorded, it’s constant, if anything comes up the manager always calls a meeting”.

The provider made sure people and their relatives could access the care and support they needed when they needed it. Everyone who used the service received the care and support they needed when they needed it regardless of any protected characteristics under the Equality Act.

People and their relatives were given a service user guide and knew how to contact the service during office hours and out of office hours. People, their relatives and staff could contact the service at any time.

A person’s relative told us, “They were great, as they have planned [mum’s/dad’s] care to fit in with my job as well, as I am a carer. It works well, as they support me to keep my job. They are very flexible”. Another person’s relative said, “The manager is lovely. I can contact her at all times. I would definitely recommend them; they have been absolutely brilliant”.

One other person’s relative told us, “I can call the office whenever I need them. They are always there to help”. Another person’s relative also said, “I can call the office easily if needed, no problem with contacting them”.

The manager said, “There is an out of hours, on-call phone which office staff share on rota, on a weekly basis. And staff know they can contact me anytime if there is something they cannot deal with or need support with”. A member of staff told us, “Yes, sometimes I personally do contact the office, maybe over the weekend, if there’s an issue. I do call them, and they come back to me”. Another member of staff said, “Yes. There are four to five people in the office, they do pick up”. We can contact them anytime and someone always picks up”.

Feedback provided by people and their relatives using the service, both to the provider and CQC, was positive, as was feedback about the service from the local authority. Staff treated people equally and without discrimination. Staff understood the importance of providing an inclusive approach to care and support and made adjustments to support equity in people’s experience and outcomes.

People had good outcomes and experiences of the service regardless of their needs, backgrounds or protected characteristics under the Equality Act. People, their relatives and staff felt confident the provider was genuinely interested in their views and considered them when developing the service.

The registered manager told us, “Clients are allowed to choose whether they want a male or female member of staff. If a client who is Muslim wants a Muslim carer, we have some staff who are Muslim, and they do the care calls” and “Some relatives ask me to persuade the client to go to hospital or access other services when they are reluctant to do so, and I visit clients in hospital. I prevent hospital admissions as much as possible by discussing things with clients and their relatives and making referrals to other services”.

The registered manager also said, “When a client's relative was abroad and couldn’t make their birthday, we did the client’s birthday celebration over the internet, and their relative was able to join in” and “When a client's family goes on holiday, I ask them to tell me and I make sure I go or a member of staff goes at least once to visit on the day of the missed family visit, not just to provide care, to just sit and chat with them, and I update the family on the client's [social media] group so they do not need to worry about their relative”.

A member of staff told us, “I work with a person who was thought to be end of life when we started working with them, but they can now walk from their bed down to the kitchen and back with assistance, they do it as a form of physiotherapy, and they can now sit on the sofa for their meals”. Another member of staff said, “I have a client, and we have a [social media] group where we put updates, and if their [son/daughter] cannot do something for their [mum/dad], they put it in the group and ask whether we can help with it”.

People were supported to plan for important life changes so they could have enough time to make informed decisions about their future, including at the end of their life. People were supported to consider their wishes for their end-of-life care, including resuscitation, and the provider kept a copy of people’s DNAR (Do Not Attempt Resuscitation) certificates to inform staff and other services.

Staff had received end of life training and knew people’s plans for their end of life and the provider and staff worked with the local hospice when necessary.