Premier Care Services

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Incidents were recorded and if needed actions were taken to prevent recurrence. Leaders reviewed what had happened and discussed learning with staff. The provider told us, “It is about being transparent, learning what we can do better and talking about things. If we need to change this, we will do that.”

Staff said they knew how to deal with incidents or accidents and firstly made sure people were ok and safe. Staff confirmed they had meetings and 1-1’s with management to discuss any learning.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider made sure where possible information was shared with healthcare professionals if people were moving between services. If possible, staff went with people to appointments or into hospital so they could share information about people’s needs. In addition, they could also obtain information about any changes when the person was being discharged. This helped make sure staff could get additional guidance, equipment or support to meet people’s changing needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff had training on safeguarding which was regularly refreshed. Staff understood their responsibilities to report any concerns. Leaders understood they needed to share information with other agencies such as the local authority, CQC and if needed the police.

People and relatives said people were safe using the service. Comments included, “[Person] is very safe. They [staff] go in and they care, they look after [person] and point things out to me for repair” and “[Person] is safe, I am confident about that. I have good communication with staff and they always err on the side of caution.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people’s safety had been identified. There were risk management plans which provided staff with details on how to support people safely. These had been regularly reviewed and updated if people’s needs changed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Prior to any care packages starting the provider assessed the environment at people’s homes and assessed any equipment being used. Assessments included areas such as trip hazards, manual handling, lighting and fire safety. Hazards or risks were identified and guidance provided for staff to know how to work safely.

If people had equipment, this was recorded and staff supported people to make sure this was serviced and operating safely. Some people had ‘lifeline pendants’ which enabled them to call for help if needed. There was clear guidance in people’s care plans for staff to remember to check people had their pendants within reach before leaving their homes.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People and relatives said staff were well trained and they were confident staff knew how to provide care. One person said, “I am confident staff know what they are doing.”

Staff were recruited safely. New staff had a period of induction which included shadowing other staff and completing training. Once staff were assessed as competent to work alone, they then received regular refresher training. Staff had supervisions and were able to visit the office for further support if they wanted.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider assessed infection prevention and control (IPC) in people’s homes. For example, environment risk assessments included information about food safety, food storage and identifying any specific IPC concerns. If there were any specific concerns, the risks management plans had guidance for staff to follow.

Staff were provided with training on IPC and food safety which was regularly refreshed. Staff had personal protective equipment and could collect additional stock from the office. People told us staff wore gloves and aprons when needed.

The provider did not always make sure that medicines were safely managed. People’s medicines administration records did not always contain all the details needed for staff to know exactly what to administer. For example, some medicines did not have the dose and frequency recorded on all records. ‘As required’ medicines did not always have clear guidance for staff to know when to administer this type of medicine. Whilst the risk of harm was mitigated by people having visits from staff who knew them well, clear guidance was needed for staff to follow.

Staff had medicines training and checks for competence. However, we found competence records did not outline what skills had been assessed and how many observations staff had completed. We shared this feedback with the registered manager who said they would address this shortfall without delay.

People were happy with the support they had to manage their medicines. They said staff helped with administering and in some cases ordering and collecting medicines from local pharmacies.