Background to this inspection
Updated
28 June 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by an inspector, a medicines inspector and 3 Experts by Experience who conducted telephone calls with people using the service and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave 36 hours’ notice of the inspection. This was to allow the provider time to start asking people using the service and their relatives if they would consent to speaking with us about their experiences. Inspection activity started on the of the 2 May 2023 and ended on 22 May 2023, by which time we had sought the views of people, relatives and staff and reviewed all additional information sent following the visit. We conducted office visits on the 4 and 5 May 2023.
What we did before the inspection
We reviewed information we had received about the service since it was registered. This included notifications sent to us by the service. Notifications are changes, events or incidents that the provider is legally obliged to send to us without delay. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We sought feedback from the local authority and professionals who worked with the service. We used all this information to plan our inspection.
During the inspection
We spoke with 11 people using the service and 14 family members about the experiences of the care provided. We spoke with the registered manager, operations director and director of quality in person and sought the views of 18 care staff via a mix of telephone interviews and emailed questionnaires.
We reviewed a range of records. This included 10 people’s care records and multiple medication records. We looked at 5 staff files in relation to recruitment, training and support. A variety of records relating to the management of the service were also reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We also reviewed recruitment records, induction and other training information, team meeting notes, client and staff rosters, audit and governance information.
Updated
28 June 2023
About the service
Premier Care – Salford Homecare Branch is a domiciliary care service who provide care and support to over 380 people living in their own accommodation within the Salford area. Premier Care is the main provider for the local authority in 4 of the 5 areas of Salford which are Swinton & Walkden, Little Hulton, Broughton and Ordsall.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of inspection, 360 people received personal care and were included in the inspection.
People’s experience of using this service and what we found
We found improvements were required with consistency in the timing and duration of care visits and audit and governance processes. Care staff often arrived earlier or later than planned and did not always remain as long as scheduled. There was also a lack of travel time provided between visits, which also affected staff’s ability to be punctual. There was a lack of audits and monitoring processes being completed within the service. What was in place had not identified a number of the issues we noted during the inspection.
The majority of people we spoke with told us they received safe care, especially when supported by their regular carer. Staff told us they were provided with training in safeguarding. However, records showed training completion rates required improvement. The provider was aware of this, and a plan was in place. New staff had been recruited safely, with all necessary safety checks completed. Risks to people had been assessed, with information in care plans on how these would be minimised as much as possible. Overall, medicines were being managed safely, though some issues we noted had not been identified through the audit process.
We have made a recommendation about medicines auditing.
People and relatives provided mixed feedback about communication with the service and involvement in their care. Some told us communication was good, any concerns were addressed, and they were periodically asked for their views about their care and if they were happy with this. However, others told us they had never been asked for feedback and had not received responses when concerns had been raised.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 29 June 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.
Why we inspected
We carried out a focused inspection of this service in May 2021. Breaches of legal requirement were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-Led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection (published December 2017) to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Premier Care - Salford Homecare Branch on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to person centred care and the audit and governance process at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.