Archived: Premier Homes

Updated 25 April 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 21 and 28 February 2017 and the first day was unannounced. The second day was arranged by mutual agreement. The inspection team on the first day of inspection consisted of two inspectors. The second day was conducted by one inspector.

We did not ask the provider to complete a Provider Information Return (PIR) on this occasion. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This was because the service had recently been inspected. We reviewed the information we held about the service including previous inspection reports and notifications. A notification is information about important events which the service is required to send us by law.

We looked around the building and observed interactions between staff and people living at the service. We spoke with four people, three staff members, the manager, who was not currently registered with the Care Quality Commission at the time of our inspection, and the provider. We looked at records relating to the service. Including eight care records, five staff recruitment files, daily record notes, policies and procedures and quality assurance records.

Updated 25 April 2017

We inspected this service on the 21 and 28 February 2017. The first day was unannounced, the second day was by agreement with the manager.

The previous inspection took place in August and September 2016 where seven breaches of the Health and Social Care Act 2008 were identified. The provider was rated as Inadequate and placed into special measures by CQC. We took enforcement action after the last inspection. This inspection was carried out to check on the improvement actions identified in the provider’s representations.

Premier Homes is a care home which provides accommodation, personal care and support for up to 17 people living with mental health needs. There were 15 people in receipt of care at the time of our inspection. Accommodation was split between five separate houses, all located within a small geographical area within the same street. People lived in small groups with between two and four people in each property. People’s needs were such, that staff support was available to them 24 hours a day, either when staff were working with people in their houses during core set hours, or at any time if people visited the office and asked for assistance.

The service did not have a registered manager as the previous manager left following our last inspection. The responsible individual had been acting manager since the registered manager had left. The directors have another company which is registered with the Care Quality Commission (CQC). At one of these services a manager had been newly appointed. Since our inspection this manager has been registered with the CQC. The directors planned that this manager would also

manage Premier Homes until the service changes its registration to become a supported living service. At this point the service will be part of the company mentioned above.

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.

Person centred risk assessments had been produced with people living at the service. The service had not taken action to minimise some of the risks identified putting people at risk from harm for example, we found a risk assessment stating someone was at risk form drinking bleach when they became unwell, yet we found they had access to bleach which was being stored under the kitchen sink. The service took immediate action once this was brought to their attention.

Medicines were not always managed safely and staff did not always follow best practice guidelines when administering medicines. There had however been a number of improvements since we last inspected.

Quality assurance checks were being completed, these did not always provide detailed information about the issues identified by them or how the service was going to address the concerns. People told us they reported concerns and these were acted on. We saw there was a formal complaints procedure in place which responded to complaints appropriately.

Records and recording across the service had improved since our last inspection they were more detailed and thorough. Care plans and risk assessments provided details about the person and their individual needs. People had been involved in their care planning and had signed to say they agree with what was recorded.

People felt safe with the care and support they received. Staff were aware of the safeguarding process and how to report any concerns they had. Staff had received up to date training in safeguarding adults and we found the policies and procedures staff were required to follow, were up to date containing reference to recent legislation.

Staff engaged with people politely and appropriately throughout our visit and people told us they liked the staff. People were supported to attend medical appointments and referrals were made in a timely manner.

Staffing levels within the service were appropriate for the current level of need. Staff recruitment was robust as the service completed the required checks to ensure staff were suitable to work with vulnerable people. Staff were provided with sufficient training to support them in their role.

People’s views were sought at resident meetings and keyworker sessions. People living at the service were mostly independent with how they spent their days, other people received support with activities of daily living. We saw the service had arranged for additional activities in the coming months for people to participate in if they wanted to.

Staff sought consent from people before providing care or support. The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. There was no one subject to a DoLS at the time of our inspection and we saw the service had considered what was in a person’s best interest within their care files.

We found improvements had been made with regards to safe care and support provided by Premier Homes since our last inspection, these improvements need time to embed in the service and we will check on these at our next inspection.

During this inspection we found three breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.