The Care Quality Commission
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Archived: Prestige Nursing Peterborough

Overall: Good read more about inspection ratings

Suite 17, 2nd Floor, Cross Street Court, Cross Street, Peterborough, Cambridgeshire, PE1 1XA (01733) 555511

Provided and run by:
Prestige Nursing Limited

Important: This service is now registered at a different address - see new profile

All Inspections

30 October and 02 November 2015

During a routine inspection

Prestige Nursing Peterborough is a domiciliary care agency registered to provide personal care for people living in their own homes. They are also registered to provide staff for care homes, hospitals and hospices. They are also registered as a nurse agency. There were no nurses being supplied by the service on the day of our inspection. There were 19 people being supported with the regulated activity of personal care in their own homes at the time of our inspection.

We carried out an announced comprehensive inspection of this service on 08 July 2014. A breach of one legal requirement was found. This was because people who used the service were not protected against the risks of receiving care that was inappropriate or unsafe. After the comprehensive inspection the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

This comprehensive inspection was carried out on 30 October and 02 November 2015 to check that the provider had followed their plan and to confirm that they now met legal requirements. We found that the provider had followed their plan, which they told us would be completed by 23 July 2015 and legal requirements had been met. We gave the service 48 hours’ notice of our inspection.

There was no registered manager in place during this inspection. There was a branch manager in place whilst arrangements were being made to fill the registered manager post. 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. The manager told us that no one being supported by the service lacked the mental capacity to make day-to-day decisions. There had been no requirements to make applications to the authorising agencies. Staff demonstrated to us that they respected people’s choices about how they wished to be supported. However, not all staff were able to demonstrate a sufficiently robust understanding of MCA and DoLS to ensure that people did not have their freedom restricted. The lack of understanding increased the risk that staff would not identify and report back to the management that people were having their freedom restricted in an unlawful manner.

Individual risks to people were identified by staff. Plans were put in place to reduce these risks to enable people to live as independent and safe a life as possible. Arrangements were in place to ensure that people were supported with the safe management of their prescribed medication.

People, where needed, were assisted to access a range of external health care professionals and were assisted to maintain their health. Staff supported people to maintain their links with the local community to promote social inclusion. People’s health and nutritional needs were met.

People who used the service were supported by staff in a caring and respectful way. Individualised care and support plans were in place which recorded people’s care and support needs. These plans prompted staff on any assistance a person may have required.

People and their relatives were able to raise any suggestions or concerns that they had with the manager and staff and they felt listened to.

There were pre-employment safety checks in place to ensure that all new staff were deemed suitable to work with the people they were supporting. There were enough staff available to work the service’s number of commissioned and contracted work hours. Staff understood their responsibility to report any poor care practice.

Staff were trained to provide care which met people’s individual care and support needs. Staff were assisted by the manager to maintain and develop their skills through training. The standard of staff members’ work performance was reviewed by the management through observations and supervisions. This was to make sure that staff were confident and competent to deliver this care.

The manager sought feedback about the quality of the service provided from people who used the service. Staff meetings took place and staff were encouraged to raise any suggestions or concerns that they may have had. These meetings and the organisation’s website and newsletter were also used to update staff about the service. There was an on-going quality monitoring process in place to identify areas of improvement required within the service. Where improvements had been identified the manager had actions in place to make the necessary amendments. However, not all actions taken were formally recorded.

08 July 2014

During a routine inspection

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 last scheduled inspection for Prestige Nursing Peterborough took place on 12 September 2013. The agency was compliant in the five regulations inspected.

We visited Prestige Nursing Peterborough on 8 July 2014. This was an announced inspection, which meant the provider was informed about our visit one day beforehand to ensure managers and staff would be available in the office.

Prestige Nursing Peterborough is registered to provide personal care for adults living in their own homes and staff for care homes and hospitals. They were also registered as a nurses agency. On the day of inspection Prestige Nursing Peterborough was providing personal care to 25 people in their own homes. There had been no nurses supplied by the agency in the last year as they had no nurses available.

The agency had a registered manager. 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.

At the last inspection, undertaken in September 2013, there were no breaches in any of the five regulations examined.

During this inspection we found that people’s welfare and safety was at risk because the provider had not made sure that all the information about people who received the service was up to date nor that risk assessments to protect the people and staff were always completed. This was a breach of Regulation 9 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

Improvements were needed to the documentation because food and fluid records were not always fully completed. This meant people might not have had enough food and drink to meet their needs.

There were a number of methods used by the provider to check the quality of the service so that any areas of concern could be identified and dealt with. However, improvements were needed as there was no action plan to show that information from the client satisfaction survey last year had been used to improve the service provided by the agency.

Staff were aware of legislation regarding the Mental Capacity Act 2005 and what it meant to the people they provided care to. They told us that training had been provided and this was confirmed during the inspection. This meant staff would recognise when an assessment under the Act was necessary to protect people in their care.

Staff knew about the people they cared for and had received appropriate training to make sure they could meet those people’s needs. Staff understood what to do if they had concerns about people’s wellbeing or safety.

People told us that staff were caring and responded well when any changes were needed, but there was a lack of continuity of staff at the weekends. They told us that they or their relative had been involved in writing and reviewing their plans of care.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 as identified above. You can see what action we told the provider to take at the back of the full version of this report.

12 September 2013

During a routine inspection

People who used the service had the right level of information to make a decision about their care. People we spoke with told us that choices were provided and respected by staff before undertaking any care and support.

We spoke with five people who used the service and they had very positive comments about the quality of the care provided. One person told us that their care was, "Absolutely brilliant." Another person told us that Prestige Nursing ' Peterborough was, "(The) best agency they have used."

People's standard of health and welfare was maintained. Staff had access to detailed care records to ensure that they provided people with safe, appropriate, individual care support.

When reviewing medication administration records (MAR) charts, we saw evidence of accurate documentation, staff training and staff competency checks to ensure that people were protected against the misuse of medication.

Staff training was in place to make sure that people who used the service received safe support and care from suitable, skilled, and knowledgeable staff.

The provider demonstrated to us that they had quality assurance procedures in place for monitoring the quality of the service delivered to ensure that people consistently received safe care and support.

22 January 2013

During an inspection looking at part of the service

During our inspection of the 22 January 2013 we did not speak with any people who used the service. This was because we were checking how the service had responded to our concerns from the previous inspection, which involved examining information and records only. However, during our previous inspection of 13 November 2012, people who used the service who we spoke with were certain that any concerns raised would be taken seriously by the provider. This was because staff members treated them in a kind and respectful way.

During this inspection, we found that people who used the service were protected from the risk of abuse because the provider had put steps in place to identify the possibility of abuse and prevent abuse from happening.

13 November 2012

During a routine inspection

All of the people who used the service that were spoken with said that they were happy. This was because people were treated with respect, supported by staff members and their care needs were met. One person told us that staff were, "Wonderful." Another told us that, "Nothing was too much trouble".

One health professional who we spoke with told us, "They [the provider] involve people in their care planning and decisions". They also told us that they felt there was a "Very good standard of care." and that, "Communication [with the provider] was good."

We found that people were placed at risk due to safeguarding processes not being followed correctly, although allegations were investigated appropriately. We also found that the whistle blowing policy did not contain detailed information of external agencies staff and people using services could contact if they had a concern and wished to remain anonymous.

Effective staff recruitment was in place to make sure that people who used the service received support and care from suitable, skilled, and knowledgeable staff.

We saw that an effective quality assurance system was in place and that meant that people's feedback was listened to, monitored and reviewed to improve the service where appropriate.