Premier Homecare

People’s experience of using this service:

People were not supported to have maximum choice and control of their lives in line with the principles of the Mental Capacity Act. Assessments had not been completed to ensure people were supported in the least restrictive way possible. The policies and systems in place at the time of the inspection did not support this practice. However, we saw improved templates and procedures were developed and ready to be rolled out across the service.

Environmental risk assessments identified concerns and issues which were not addressed. Individual risk assessments were not updated when people’s needs changed to ensure risks were mitigated and managed.

Records held by the provider on the support people needed and the support the service provided were not complete. The new reporting paperwork should address this. However, at the time of the inspection there were gaps which could result in key elements of people’s support needs being missed.

Staff were well supported to meet people’s needs and received training as required and requested.

People told us they were well cared for by staff who visited them and felt safe when being supported. One person told us,” They [staff] are all very friendly and chatty, I have no problems with them at all. It’s everything they do, they have a lovely caring attitude, they ask me about myself, my family and my life.”

People were actively encouraged to access the community and the service organised events to engage people in activity.

Quality sense checks were completed monthly by office staff who visited each home to ensure people were receiving the service they needed. An annual questionnaire was also completed.

The provider monitored the service provided and developed action plans to drive improvement.

Rating at last inspection: The last inspection report was published on 21 September 2016 and was rated good overall and good for all key questions.

Why we inspected: This inspection took place as part of planned programme of comprehensive inspections in line with our methodology.

Follow up: This inspection identified three breaches to the regulations in relation to identifying and managing risk, adhering to the principles of the Mental Capacity Act and the lack of contemporaneous notes. The provider will be required to submit an action plan to show how they intend to address the concerns and ensure they meet the requirements of the regulations moving forward. We will continue to monitor the service in line with our ongoing monitoring of all services we regulate.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Before the inspection we looked at all of the information that we held about the service. This included information from notifications received by us. A notification is information about important events which the provider is required to send to us by law.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. However, the registered manager was not available. There was a manager providing ongoing management of the service who was available on the day of inspection.

Staff received training to protect people from harm and they were knowledgeable about reporting any harm. There were a sufficient number of staff and recruitment procedures ensured that only suitable staff were employed. Risk assessments were in place and actions were taken to reduce identified risks.

The provider had procedures in place in relation to the application of the Mental Capacity Act 2005 (MCA). Staff we spoke with confirmed they had received training regarding MCA. The manager and the staff were knowledgeable about these. They were aware of the circumstances they needed to be aware of if people’s mental capacity to make certain decisions about their care changed.

Staff were supported and received ongoing training to do their job. The staff were in contact with a range of health care professionals to ensure that care and support was well coordinated. Health professionals we spoke with were complimentary and positive about the service. Risk assessments were in place to ensure that care and support could be safely provided.

People’s privacy and dignity were respected and their care and support was provided in a caring and a patient way.

A complaints procedure was in place. Complaints had been responded to, to the satisfaction of the complainant and in line with the provider’s procedure. People felt able to raise concerns with the staff at any time.

The provider had quality assurance processes and procedures in place to monitor the quality and safety of people’s care. People and their relatives were able to make suggestions in relation to the support and care provided.

We found that the plans of care held in the office and people's homes contained up to date information. We saw that they contained the information staff members needed to ensure that the health and safety of people was promoted.

People using the service told us that they had received the care and support they needed and that staff were excellent.

We saw that the people's individual medication was available and monitored and found that the provider was taking action to ensure it was administered safely and recorded accurately.

People using the service told us that they received a reliable service and that staff members were kind and respectful towards them.

The records held ensure that people are protected against the risks associated with unsafe or inappropriate care and treatment.

The plans of care contained the information staff members needed to ensure that the health and safety of people was promoted.

People who used the service and their relatives told us that people received the care and support they needed and that staff were very kind.

The provider responded appropriately to any allegation of abuse and staff we spoke with showed us that they knew how to ensure that people were safe.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

Complaints were dealt with appropriately and people were able to access and use the complaints system in a format that met their needs.