We carried out a review of the data available to us about PRN Homecare - Bognor Regis on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about PRN Homecare - Bognor Regis, you can give feedback on this service.
PRN homecare is a care at home service providing personal and nursing care to 57 people at the time of the inspection. Home care services provide care to people in their own homes.
Not everyone who used the service received personal care. At the time of the inspection no one was receiving nursing care. CQC only inspects where people receive personal or nursing care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People were kept safe by well trained, caring staff who enjoyed their jobs and got on well with people. A person told us, “I feel very safe and relaxed with my new carer, because they are good natured and a natural carer, this mean they know their job well and is the right personality. They want to help. I didn’t have to express any preferences and I do not want to change my current carer at all."
Staff were recruited safely and since the last inspection the detail in care plans had been improved which meant staff could give better person-centred care. Risks were well managed, and staff had clear guidance on what to do in the event anything went wrong.
Staff training had continued during the COVID-19 pandemic, both online and in person when it was safe to do so. Staff were trained in good infection control and people felt reassured by the calm support of the staff. A person said, “I would say that carers know their job well, they are certainly well equipped, and they come dressed in all their gear, masks, gloves. They put all the stuff on before they come in and they wash their hands and have disinfectants.”
People enthused about the care they received from PRN Homecare. Everyone we spoke to was happy with the care and many people said the carers were more like friends or family as they knew them so well. People told us they felt the care was above and beyond. For example, carers took time to talk to people about things that were important to them. A relative told us, "For a start they all are very jolly and cheerful when they come, it's all nice smiles, which we can’t see under masks, but we can detect in their voices. They always ask how my relative is, spend a good amount of time talking with them.”
The service was efficient and responsive. People told us they had input into their care and the staff always talked to people and asked for consent during care. Relatives told us they felt included in the decisions about care, “We work with the carers because my relative will probably deny that their needs have increased, we will need evidence. The carers are kind and gentle they all have the patience of saints. They know how to talk with (my relative), and they joke with them and then my relative is more co-operative.”
The registered manager provided people with a rota of the staff who would be visiting in the coming week so people knew who was going to be calling and providing care. People could request changes of staff or time and the registered manager would sort it out. Staff and people said how flexible the service was. A person said, “I called them to ask them if we could change a visit because my relative was going to the hospital, and another time it was about extra visit on specific week, the person who answered the call wasn't sure so they told me that somebody will come back to me with answer, and they did call back, and sorted as we wanted.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 (8 February 2020)
The provider completed an action plan after the last inspection to show what they would do and by when they would improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This inspection was prompted by our data insight that assesses potential risks at services, concerns raised and based on the previous rating. This inspection enabled us to review the previous ratings.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for PRN Homecare on our website at www.cqc.org.uk.
PRN Homecare- Bognor Regis is a domiciliary care agency providing care and support to people living in their own homes who have a range of needs. CQC only inspects where people receive personal care. Not everyone who used the service received 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 the inspection 64 people were receiving personal care.
People’s experience of using this service and what we found
People were supported by familiar and consistent staff who knew their care needs and understood how to meet these safely. Risks to people had been assessed, however further information was needed so that staff could safely meet people’s identified health needs and associated risks. There were enough staff employed to meet people’s needs and there were clear recruitment procedures in place. However, full employment histories were not always obtained from applicants to check their suitability to work with the people they supported.
People and their relatives told us they felt staff who supported provided safe care. Staff told us they would report any safeguarding concerns. People told us they were supported by reliable staff who were on time. People were supported, when required, to receive their medicines as prescribed.
Staff received training that equipped them in their role. However, we found that they had not received specific training in the mental capacity act and this had impacted on compliance with this legislation.
People told us staff obtained their consent before supporting them with care and support. However, people were not always supported to have maximum choice and control of their lives. The provider did not have records to evidence that people were supported in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Where required, people were supported to eat and drink sufficient amounts to remain healthy and were supported to access healthcare professionals when needed.
People and their relatives told us they were happy with the care they received and thought the staff were kind and caring. Staff supported people to maintain their independence where possible, and to remain involved in decisions about their care. People told us that staff respected their dignity and privacy. Staff supported people to develop and maintain important relationships.
People had care plans which were reviewed regularly. They contained details about people’s individual needs. However, further improvement was needed to develop more person-centred care plans, that captured people’s protected characteristics and life histories.
People were supported by a consistent team of staff who knew them well. This meant that staff and the provider understood people's individual needs and tailored the service where possible, to support people. People knew who to make complaints to and were confident they would be listened to.
People and staff told us that the provider and manager were approachable and responsive. People were able to feedback their views of the service.
Quality assurance processes and systems in the service were not always robust. Some notifications which are required to be sent to CQC, had not been submitted. These were submitted following the inspection and the provider has assured us any further relevant incidents will be notified, as required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 8 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
Enforcement
At this inspection, we identified breaches of regulations in relation to the Mental Capacity Act, the protection of people's rights and freedoms, notifications of incidents to CQC and quality assurance systems. 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
PRN Home Care provides personal to people in their own homes. At the time of the inspection personal care was provided to 86 people whose ages ranged from 39 to 97 years and had needs such as physical disability, sensory impairment, dementia and frailty due to old age
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last inspection carried out on the 7 August 2014 the service was rated Good. At this inspection we found the service remained Good.
We carried out this inspection as part of our routine schedule of inspections and to check that people were still receiving a good standard of care.
Staff were trained in adult safeguarding procedures and had a good awareness of what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe with the staff which was also echoed by their relatives
Care records showed any risks to people were assessed and there was guidance of how those risks should be managed to mitigate any risks of harm. People said they received safe care.
There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures ensured only suitable staff were employed.
Medicines were safely managed.
There was a good system of training and supervision of care workers.
The CQC monitors the operation of the Mental Capacity Act (MCA) 2005. The staff and deputy manager were aware of the principles of the MCA and made referrals to social services where it was assessed people did not have capacity to consent. However, the service did not have a set procedure for assessing and recording capacity and training in this for staff was limited. The deputy manager took immediate steps to address this by arranging staff training in the MCA.
People’s consent to care was sought and this was recorded in the care plans.
People were supported with food and drink where this was needed.
People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed. Staff worked well with health care services such as community nurses to ensure health care needs were met.
People were treated well by the staff who formed positive relationships with people. Care workers treated people with respect and dignity and promoted their privacy.
People received individualised care based on their needs and preferences, which was reflected in their care plans. People said they were involved in decisions about their care and knew how to make a complaint if they needed to.
The service had good systems to monitor its own performance to ensure care was reliable and safe. These included seeking the views of people who received care, their relatives and health and social professionals. Audits were also used to monitor the effectiveness and quality of the service and action was taken where any shortcomings were identified.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The inspection took place on the 7 August 2014. This was an announced inspection. The provider was given 48 hours’ notice of the inspection as we needed to be sure that the office was open and staff were available to speak with us.
PRN Homecare is a domiciliary care service that provides nursing and homecare services to adults within their own homes. PRN Homecare staff support people with a variety of needs including those related to living with dementia, mental health, older age, physical disability or sensory impairment. At the time of our inspection the service supported 118 people.
There was a registered manager in place for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
People and their relatives told us they were happy with the service they received. One person told us, “PRN are superb. They are flexible and every single carer I’ve had has been on time and has been kind and helpful”. Another person told us, “They’re brilliant. I can’t fault them”. People told us they were supported by kind and caring staff.
There were robust recruitment procedures in place and staff were supported to deliver the care and support required to meet people’s needs. Staff received essential and additional training and were encouraged to gain further relevant qualifications. Staff completed an induction programme which included shadowing other staff to learn about their role. Their practice was observed to ensure that they were competent to be able to deliver the care people required.
Staff felt supported by the management team and were positive and enthusiastic about their roles. One staff member told us, “I would definitely recommend it to my own family”. There were enough qualified and experienced staff to meet people’s needs.
The provider had good systems in place to keep people safe. Safety risks were identified, assessed and reviewed. There were instructions for staff on what action to take in order to reduce risks identified. Staff received safeguarding training and were able to tell us actions they would take if they had concerns people were at risk of abuse. We saw that where concerns had been identified the provider took the required action.
People told us they were involved in the planning and review of their care. Where people were unable to do this, staff considered the person’s capacity under the Mental Capacity Act 2005 (MCA). Staff observed the key principles of the MCA in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.
Prior to our inspection the provider informed us that there had been six medicine errors in the last 12 months. We looked at how the provider managed people’s medicines so that they received them safely. The provider had taken action where medicine errors had been identified and put systems and processes in place in order to reduce the risk of further errors.
If needed, people were supported to eat and drink and maintain a healthy diet.
The service provided was flexible and responsive to people’s needs. People were involved in the initial assessment of their needs and in the planning and review of the care plan which identified what and how care should be provided. People told us that the service was flexible and promoted people’s independence. One relative told us, “They work with him on what he needs on any given day”.
There were quality assurance procedures in place and the provider sought feedback through questionnaires from people, relatives and professionals. People knew how to make complaints and action was taken to resolve any concerns. The provider took steps to ensure that care and support was provided in an appropriate way and, where necessary improvements were made.
People and their relatives were all complimentary about the service that they received from the agency. One person told us, "The carers are very nice, kind and capable.' A relative told us that the carers were always kind to their relative; they said 'They are kind and never patronising. They are friendly and cheer (person sing the service) up.'
We found that people had planned care that met their needs. We also found that people's consent had been obtained prior to treatment where appropriate.
We found that enough staff worked for the service to meet with the requirements of people that used the service. We also saw that staff had been trained appropriately and took infection control seriously.
We found that the service had systems in place to monitor the quality of the service that they were providing.
Everyone said that they had been given a copy of their care plan. Some people said that they had regular contact with the agency to review their care and that they had completed questionnaires about the quality of service provided.
Most people said that care workers arrived on time for visits. One person said, 'On very rare occasions staff can turn up late however we always get a call to warn us of this'.
All of people told us that they received the same staff on a regular basis and that this had helped them to build up a relationship of trust with their care workers.
Everyone we spoke with said that care workers were friendly and helpful.
People told us that they had been consulted about the times of their visits.