Premier Homecare

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment, the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. For example, accidents and incidents were recorded and analysed and action taken to reduce the risk of them happening again. Any analysis was shared with service managers to look at lessons which could be learnt on a wider organisational level.

The provider had systems in place to review and investigate accidents, incidents, and safeguarding concerns. The service manager demonstrated their passion for continuous learning throughout the service and embedding a culture of openness and transparency.

Feedback from staff was mostly positive, and staff told us they felt they could approach management if they had any concerns, and that communication has improved since the new manager has been in place. Staff, specifically one staff member told us, “New manager is really helpful, [manager] had been really good with me. They know my situation, and they work my rotas, so I have a work life balance and balance my caring responsibilities.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. The management team were actively working on the rotas to ensure there was continuity of care. Staff told us they had seen improvements with their rotas and being allocated appropriate travel time which has previously been an issue within the service.

People told us that their carers arrived on time and that they would prefer to have rotas but if they ring the office they are informed who will be visiting them. Following, feedback from us the service manager assured us they were working on the rotas and ensuring continuity and that all service users will be provided with rotas.

The provider had a new electronic call monitoring system which allows greater oversight of visits, punctuality, care records, and continuity of audits for reporting purposes. The care planning system enabled paramedics to log in, to access peoples current records, offering safe, continuity and transition of care.

The provider worked well with other health and social care providers and feedback we received from external healthcare providers was positive. One healthcare professional told us, “In our professional experience, the service has been responsive to the needs of the people they support and has worked collaboratively with us where required.” The local authority described the cooperation with the above service and the continuity of the relationship in the provision of services during the contract period as good. The local authority also shared with us that the service actively took part in market engagement events across 2024 and 2025. However, the local authority also shared some more recent concerns around the service had cancelled scheduled visits for several people and the escalation process was not followed with the local authority. Some concerns around visits also led to complaints around people’s medication time laps and missed visits. The local authority was assured by the services response to these challenges and told us these were without delay, and the service communicated progress on the investigation in a transparent manner along with lessons learnt.

In addition, Service Manager is being actively supported by Regional Manager and internal Compliance Team.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. The provider shared concerns quickly and appropriately.

Staff had undertaken training in relation to safeguarding and there were policies and processes in place to report concerns. Staff understood their responsibilities in relation to safeguarding people and knew how to recognise the signs of potential abuse including the steps they should take to report these. One person told us “There have been times when [staff] have brought something up to my attention and on one occasion, [staff] rang 999 because immediate help was needed so they use their initiative. “We saw evidence of safeguarding being discussed in staff meeting minutes and newsletters.

People’s care records contained basic information in relation to people’s care needs and mental capacity. Capacity assessments were completed but were not always relevant or necessary. Staff understood people’s capacity to make decisions about their care and support and used people’s preferred method of communication to enable people to be involved in decisions. This is because staff knew people they support well. However, care plans did not always contain person-centred detail and if staff had not known people well, these care plans would not always support staff to deliver person centred care. From the commencement of our assessment the service manager has been open and transparent around identifying that care records needed reviewing and improving to make them more person-centred. During our assessment we could see some care plans that had been recently reviewed and contained good person-centred information. These reviews are taking place alongside people’s care records being moved over to the service’s new electronic system that compliments more person-centred records. During our assessment we saw a detailed action plan that the service had devised to identify shortfalls within the service and drive improvement.

People and their relatives told us they felt safe and cared for with the service.

The provider worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them.

We found people had been assessed for risks and measures had been put in place to reduce the likelihood of harm. For example, we saw a medication risk assessment was in place that identified and reduced the risk of medication being openly accessible to a person living with Dementia. However, we could not see evidence of consistent reviews of people’s care plans and risk assessments. This was identified as an ongoing improvement by the service manager to continue to improve the safety of the service.

Staff told us they would report any risks to the manager and that they would update the clients care plan and inform staff. Relatives told us, “I am sure my [relative] is safe in their company I think that they are good agency.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff had undertaken health and safety training as well as fire training. Staff knew how to escalate concerns in relation to maintenance. The systems in place meant these were addressed in a timely way. Risk assessments were in place to evaluate the safety of the environment and ensure staff were safe whilst supporting people in their own homes. This included ensuring equipment was in good working order and reporting any concerns about equipment or the environment. Risk assessments for people considered other risk factors such as fire and emollients.

The provider made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together well to provide safe care that met people’s individual needs.

Since coming into their role, the service manager has improved the processes around supervisions and spot checks. The manager has started to embed regular supervisions with staff, and this was evidenced by records and what staff have told us. Regular competency assessments took place. We reviewed training records and found staff had received appropriate training and been inducted into their roles. Staff told us they received regular training and support. When we reviewed the training matrix and there was some expired training. When raised to the service during our feedback, the branch manager assured us that they were actioning on all staff completing their expired training and this was also evident on the services action plan. Staff also told us that they are completing training.

People told us they felt safe with staff. One person told us “The staff definitely know what they're doing and are well trained.”

Recruitment records showed staff were recruited safely. This included an enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Staff had received full inductions and multiple references from previous employments had been sought.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had policies and procedures in place relating to infection prevention and control (IPC). Staff had received training on the prevention and control of infection. Spot checks were carried out to observe staff’s practise and all people we spoke to told us that staff always wore their personal protective equipment where appropriate.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff involved people in planning, including when changes happened.

There were systems and processes in place for the safe management and administration of people’s medicines. Records showed that staff received medication training. The provider had a medication policy in place and ongoing assessment of competencies for staff. Not everyone needed support with their medicines, but when they did, people received their medication from trained and competent staff and had this need risk assessed and detailed the level of support people required. The branch manager has implemented regular audits to ensure people received their medication in a safe way. The audits were reviewed to identify any trends or patterns where medications had been missed or not given to ensure lessons were learned within branch and as part of a wide organisation. We saw evidence of safe medication administration being discussed in staff communications.

People and relatives told us people received their medicines with the support of staff. One person told us “[staff] mainly come in to do my medication and [staff] do a very good job, but [staff] will often ask if [staff] can do anything else, I have never missed medication because of [staff].”