Background to this inspection
Updated
20 September 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The team consisted of one inspector and an Expert by Experience. An Expert by Experience is a person who
has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the
provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours' notice of the inspection. This was because we needed to be sure that the
provider or registered manager would be in the office to support the inspection.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback
from the local authority and professionals who work with the service. We contacted Healthwatch, which is
an independent consumer champion that gathers and represents the views of the public about health and
social care services in England.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with seven people who use the service about their experience of the care provided.
We spoke with four members of staff, including two care workers, the registered manager and quality
manager.
We reviewed a range of records. This included four people's care records and multiple medication records.
We looked at four staff files in relation to recruitment and supervision performed. A variety of records
relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality data
and a variety of policies.
Updated
20 September 2019
About the service
Prime Care at Home is a domiciliary care service. It is registered to provide personal care to people living in their own homes in the community, including older people and people living with dementia. 23 people received a regulated activity of personal care at the time of the inspection. The service can support up to 26 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People’s needs associated with risk had been assessed, but not fully explored to ensure staff had sufficient guidance to support and manage all known risks. Safeguarding systems were in place to keep people safe from harm. People and their families felt safe with the staff that cared for them. Recruitment processes were robust enough to ensure people employed were safe to work with the people who used the service. Where people required medicine, this was administered as prescribed and in a safe way. People were protected from cross contamination because staff followed infection control policy and procedures. Lessons were learned and action taken when things went wrong.
People consented to the care and support, but those who lacked capacity had no mental capacity assessments completed for decisions they needed to make, or decisions made in their best interest. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People’s needs were assessed and delivered as reflected in their care plan. Staff received sufficient training to support them in their role. People were fully supported to have sufficient to eat and drink. People attended appointments, such as hospital or chiropodist to help achieve a positive outcome for people’s health and wellbeing and were fully supported by staff.
People were cared for by kind, compassionate and caring staff. There was an opportunity for people to discuss their care and support on a regular basis. Advocate support was acquired if people needed support to express their views. People were shown respect and their dignity was protected always.
People’s care plans were written by them and included choice, needs and preferences. People’s communication needs were appropriately accommodated. People were supported to avoid social isolation and supported to follow their hobbies and interests. Systems were in place to monitor and address complaints. Staff had been trained in end of life care. Policy and procedures in regard to end of life care ensured people had the opportunity to share and understand their wishes, needs and preferences.
The provider promoted an honest and open culture. The provider understands and acts on the duty of candour. The registered manager was aware of their responsibility and had a clear oversight of the service. The management were open and transparent with a willingness to learn and improve. The provider worked with other professionals and developed networks within the community.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: Good (report published 13 December 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.