Premier Care Limited - Specialised Services

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (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 did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat each other with respect.

We observed staff treating people with kindness and respect. The staff we spoke with demonstrated a caring attitude about the people they supported. Staff provided examples of the positive impact they had with people or shared concerns about shortfalls in the service that impacted on people.

Staff who worked as, ‘support workers’ spoke highly of other ‘support workers.’ They told us, “All [support workers] are kind, caring, and dedicated to providing high-quality care. They consistently demonstrate professionalism and commitment despite challenging working conditions” and “Many [support workers] genuinely care about service users and often go above and beyond to meet their needs, despite difficult circumstances.” Unfortunately, the wider culture and the previous management did not promote and support this approach until very recent changes were implemented. Staff had reported a culture of bullying and the impact this could have on the quality of care provided.

We observed one person being treated in an undignified way and staff confirmed this issue had been happening for months. People had been unable to shower in their own house and were taken to a different property in the same street.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Care planning was poor. We could not be assured people’s needs had been thoroughly assessed. Care plans contained some basic information about people’s religion and ethnicity and a biography outlining previous employment and information about relationships that were important to people.

People were supported by regular staff who knew them well. This will have made a difference as staff were likely to have been aware of people’s preferences through regular contact. The staff we spoke with singled out the deputy manager for praise. They told us, “[Deputy manager] knows the service users really well and this helps the service to run more smoothly” and “[Deputy manager] is really helpful, and he is good at engaging with the people.”

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Care planning was poor. Information within care plans was not coherent as there was contradictory information about what people could and could not do. We could not be assured people’s needs had been thoroughly assessed.

Three people had been supported to go on holiday together. They told us, “The staff are smashing, they are very nice, they took us to Wales recently and we had a nice time.”

Staff had told us one person’s care had been reduced to 10-minute medicine calls. This meant their other needs could not be met. They needed support to enable them to be more independent and to keep them safe. This was escalated during the assessment. The provider was responsive and met the person to reassess their needs.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We observed staff showing concern for people’s wellbeing in a caring and meaningful way. However, the people using the service had complex needs and staff did not always have the right type and right level of training to respond to their needs effectively and safely.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

We spoke to 10 staff and 9 expressed concerns about how they had been treated by the previous management team. This had a significant impact on staff wellbeing. Staff reported an unprofessional culture and a culture of bullying. They also reported an improvement in recent months when the deputy manager returned and since the appointment of new senior leaders.

Staff told us, “I have experienced bullying, intimidation, discrimination, unfair treatment, and a lack of procedural fairness”, “Before it was terrible…[Previous management] were rude to the staff and looked for reasons to suspend staff. They would target some staff” and “They would threaten us by saying we would not get shifts. I was on leave and I got a call to say I needed to come to the office. If I don’t come, I won’t’ be allocated shifts. I had to come, it was made mandatory. They would pick on staff and not give people shifts.”

Other staff told us they would be allocated additional shifts without their agreement and when they were unable to attend the shift, they were given the responsibility to find a replacement.

All employees had access to an employee assistance scheme providing access to guidance and support in relation to a wide range of issues including finances, health and counselling. The provider had mental health first aiders and a reward system called, “Cera Stars”.