Premier Care Limited - Specialised Services

On this page

• 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

Responsive – this means we looked for evidence that the provider met people’s needs.At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

This service scored 43 (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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

The care plans we reviewed were not fit for purpose. The format was not suited to a supported living setting. They were not always accurate, and they were not up to date. We could not be assured they were person centred. There was no evidence people were involved in planning their care. We could not be confident care plans genuinely reflected people’s needs, preferences and long-term aspirations.

Tenants did not have control over who they lived with. They had not been fully consulted about who moved into their homes and this impacted on their wellbeing and quality of life. People told us, “We were not consulted about [tenant] moving in. [Tenant] also smokes at night and sets the alarm off…[tenant’s] visitors are rude to us and we have to have a lock on the fridge as [tenant] takes our food.”

One house had not had a consistent supply of hot water for a number of months. People were being taken to a different house to have showers. This was not person centred. The issue had been resolved by the end of the assessment.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Staff and the previous management team did not always have the skills and experience to understand the care needs of the people who used the service. This impacted negatively on how they interacted with other services and impacted negatively on people’s care. Staff did not always identify and take appropriate action when there was a gap in people’s care. This included where people may have been eligible to receive more care or support.

The local authority was in the process of reassessing everyone to help ensure people’s needs were understood. They had shared concerns prior to the assessment about people’s needs not being met and care packages not being clear.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Care plans did contain some basic information about people’s communication needs. However, the quality of the care plans was poor and we could not be confident they were accurate or comprehensive. Detailed communication care plans were not in place to make any difficulties people had with their hearing or speech and how best to communicate with them clear. We could not be assured staff fully understood people’s communication needs and provided information in a way they could understand.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

There was no record of any complaints being recorded in the previous 12 months. We had met with one family member who had made a complaint and the providers service improvement plan had identified this person had not been responded to and needed an urgent response.

The new management team had already made changes to the culture of the locations main office, and we saw both people and staff coming to the office for support. We observed good interactions between people and staff. We also saw evidence of face-to-face quality checks and minutes of resident meetings. People also had long standing relationships with regular staff who they felt able to talk to.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

We could not be assured people’s care, treatment and support was accessible, timely and in line with best practice, quality standards and legal requirements. It had been acknowledged by the provider improvements were needed to ensure staff had right level of training and experience to meet the needs of the people using the service.

Staff told us one person had not been able to shower in their own house for months due to the shower not being accessible. Renovations were planned for all the properties, but no clear timescale was in place.

The office operated 24 hours a day, 7 days a week, with an open-door policy. A member of staff was always available to respond promptly to people’s needs.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this.

The provider had failed to meet people’s needs. This had resulted in a very poor-quality service. People did not have good outcomes and experiences of the service. Staff were not supported to fully understand the complex needs people had in relation to mental health and substance misuse. This meant people were at risk of not receiving the support they needed to live a good life.

Recent changes were evident with a new management team in place and work was starting on improving all aspects of the service.

It was not clear if people were always 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.

No one was being supported with end-of-life care at the time of the assessment. It was not clear if people had been consulted as this was not factored into people’s care plans.

The provider had outlined plans to introduce more comprehensive care plans which will include the option to plan for end-of-life care if required.