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Prestige Nursing Norwich Good

Reports


Inspection carried out on 26 March 2019

During a routine inspection

About the service

Prestige Nursing Norwich is a domiciliary care agency that provides personal care and nursing support to adults living in their own home. It is owned and operated by Prestige Nursing Ltd. There were 41 people using the service at the time of this inspection. The service specialises in providing palliative care and complex care funded by NHS Continuing Health Care. The agency also supply staff to other providers, but this is not covered by this inspection.

People’s experience of using this service and what we found

Feedback from people using the service was unanimously positive and all the people we spoke with recommended the service.

The registered manager had recently left. The provider had in place temporary management whilst they recruited a new manager. We found governance and auditing processes were not sufficiently robust to minimise risk and ensure best practice was appropriately promoted and recorded. We have made a recommendation about their recording and auditing processes. The service was organised, and management was found to be open and accessible. The management dealt with any concerns or complaints quickly and appropriately. The views of people and staff were actively sought by managers to develop and improve the service.

People were protected from abuse, neglect and discrimination. Staff ensured people's safety and acted when necessary to prevent any harm. We found risks assessments were mostly thorough. However, we made a recommendation to the provider to review their risk assessment practice to ensure all risk were considered and sufficient details were recorded. People received their medicines according to prescriber’s instructions.

Recruitment practice was thorough and ensured there were sufficient staff of appropriate character to provide consistent support. Staff received comprehensive training and nurse led support ensured they were competent to carry out intensive and complex, health and social care. Staff monitored people’s health and helped them access health care services when they needed them.

People were usually 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. The provider had a specialist nurse to support best practice in caring for people living with dementia.

Staff were described as professional, reliable and caring; they promoted people’s independence and dignity. The provider completed comprehensive person-centred care plans; they completed regular reviews and were responsive to changes in needs. The provider regularly sought feedback from people using the service to ensure the service was meeting people’s preferred outcomes. The provider was skilled and experienced at providing end of life care.

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 4 August 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 8 June 2016

During a routine inspection

Prestige Nursing Norwich is registered to provide Nursing Care and Personal Care. It currently provides a service to 32 people living in their own homes.

This announced inspection took place on 08, 09 and 15 June 2016. At the time of the inspection there was a registered manager in place. 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.

People felt safe and staff knew what actions to take if they thought that anyone had been harmed in any way. There were procedures in place which were being followed by staff to ensure that people received their medication as prescribed. Risk assessments had been completed to identify and reduce risks to people where possible however some required more information.

There were enough staff available to meet people’s needs. Staff received the support and training they needed to carry out their roles effectively.

Staff were kind and compassionate when working with people. They knew people well and were aware of their preferences, their likes and dislikes. People’s privacy and dignity were upheld.

Staff monitored people’s health and welfare needs and acted on issues identified.

People were provided with a choice of food and drink that they enjoyed.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager.

The registered manager and other staff obtained the views from people that used the service, their relatives and staff about the quality of the service.

Inspection carried out on 22 January 2014

During a routine inspection

We looked at the care records for six people using the service. We found that for each of these six people, there were detailed records for staff to follow about their care needs. There were also detailed risk assessments to protect the person from harm. One relative we spoke with told us, "We've never had a problem, the support has been fantastic." Another relative told us, "The care has been outstanding".

We looked at the records for six members of care staff working for the service. We found that Prestige had ensured these six members of staff were suitably experienced and qualified to care for people. The service had also ensured that these members of staff were of suitable character to work with vulnerable people. When describing the care staff that visited their relative one relative told us, "They're first class. The care is always great". Another relative told us, "They're very diligent. They just get on with it."

We found that the service had a system in place to monitor the quality of the service it was providing and to identify any areas for improvement. The service was also undertaking surveys in order to get feedback from people using the service.

We found that the service had an appropriate complaints policy in place, and was investigating complaints in line with that policy. People had been made aware of the complaints system.

We found that the service was keeping securely appropriate records for people using the service and for staff.

During a check to make sure that the improvements required had been made

We visited the service on 27 December 2012 and found gaps in medication records. We asked the provider to follow this up with an action plan and documentation to demonstrate when they would comply with this regulation. We received an appropriate action plan from the provider on 12 February 2013 to inform us they were now compliant with the regulation.

Inspection carried out on 27 December 2012

During a routine inspection

We spoke with three people who use the service via telephone. All the people were positive about the provider and the staff. None of the people we spoke to had any complaints. One person told us that the staff were very polite and caring and were good at their work. Another person told us that she was satisfied with the service she was receiving from the provider and was able to rest from looking after her husband when staff were around. All the people told us that they were aware of their care plan being delivered and that staff had spoke to them about it. People also told us that they knew in advance which staff were coming to look after them and usually was the same people which they liked.

We spoke to staff who told us that they were supported by having regular supervision and training. Staff told us that they had spot checks carried out to ensure good delivery of care was being delivered and to support staff.

Inspection carried out on 12 October 2011

During a routine inspection

We spoke with seven people who were using the service. They told us that their needs were met and that they were consulted about the care and support that they were provided with. People were complimentary about the staff that cared for them and told us that the staff always treated them with respect and listened to them. They told us that the staff members that visited them were kind, friendly and reliable and knew how to assist them with their palliative care and support. They told us that they felt safe using the service and that the staff were well trained.