Archived: Premier Healthcare Solutions

Premier Healthcare Solutions is a Domiciliary Care Agency that provides care and support to adults of all ages, in their own homes. The service provides help with people’s personal care needs in Hayle, Redruth, Camborne, Penzance and surrounding areas. The service mainly provides personal care for people in short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals.

At the time of our inspection 28 people were receiving a personal care service. These services were funded either privately, through Cornwall Council or NHS funding.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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 and associated Regulations about how the service is run.

People we spoke with told us they felt safe using the service and told us, “Its perfect [the service] I couldn’t ask for anything more” and “I’ve got no complaints at all.”

People received care from staff who knew them well, and had the knowledge and skills to meet their needs. Staff were aware of people’s preferences and interests which enabled them to provide a personalised service. People and their relatives spoke well of staff, comments included, “The girls [staff] are well trained” and “The standard of care is very high.” Care plans provided staff with clear direction and guidance about how to meet people’s individual needs and wishes.

People told us staff always treated them respectfully and asked them how they wanted their care and support to be provided. People had a team of regular, reliable staff, they knew the times of their visits and were kept informed of any changes. No one reported ever having had any missed visits. People told us, “They [the service] are very reliable” and “If staff are running late they [the service] always ring to let me know.”

Staff had completed training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service.

The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected.

There was a positive culture in the service, the management team provided strong leadership and led by example. Management were visible and known to staff and all the people using the service. Staff told us, “The management are very approachable and supportive” and “I am proud to work for the company. I enjoy the wide diversity of service users and I believe we have a good solid group of carers, all of whom enjoy the job.”

People and their relatives said they knew how to make a formal complaint if they needed to but felt that issues would be resolved informally as the management and staff were very approachable. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

At this inspection because we only looked at care records we were unable to answer all of our five questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

From a records perspective we were able to make a judgement that Premier Healthcare Solutions was responsive.

We looked at nine people's care records to check for improvements. We found that every record had been reviewed and updated into a new format and there was a plan in place to review all care records at least six monthly. Care plans gave clear instructions for staff to follow to ensure people's needs and wishes were met.

This meant that people were protected from the risk of unsafe or inappropriate care because care plans contained accurate information about how care should be provided by staff.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

During our inspection of Premier Healthcare Solutions we saw evidence to support our judgment that overall the service was safe.

However, we found some improvements were required in relation to people's care records. This was because care plans did not record sufficient detail of how the care should be delivered by staff to meet people's assessed needs. We have asked the provider to tell us what they intend to do to meet the requirements of the law in relation to maintaining accurate and appropriate records.

People told us they felt safe. People told us they felt their rights and dignity were respected.

People were protected from risk because staff knew what to do if safeguarding concerns were raised. Premier Healthcare Solutions had policies in place to help minimise against the risk of abuse including financial abuse.

People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. There were robust recruitment procedures in place that included a Disclosure and Barring Service (DBS) check.

Is the service effective?

During our inspection of Premier Healthcare Solutions we saw evidence to support our judgment that the service was effective.

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Staff understood people's needs and delivered care in line with those needs.

People we spoke with told us they had regular staff visiting them and they knew the time staff were going to arrive. They told us the service kept them informed if there were any changes to the timing of visits or if staff were running late.

Is the service caring?

During our inspection of Premier Healthcare Solutions we saw evidence to support our judgment that the service was caring.

We visited two people in their own homes, met one relative and spoke with the two people on the telephone. People we spoke with told us they were happy with the service provided by Premier Healthcare Solutions. Comments from people included, 'Can't praise them [staff[ enough', 'excellent service', 'wonderful ' I like them all [staff]' and 'staff are lovely, kind and caring'.

Where shortfalls or concerns were raised these were taken on board and dealt with.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

During our inspection of Premier Healthcare Solutions we saw evidence to support our judgment that the service was responsive.

People we spoke with knew the staff who worked in the office and indicated to us they would feel comfortable raising a complaint if they needed to.

The service was flexible and could be adapted to meet people's needs and wishes. People told us staff always asked if there was anything else they needed before completing their visit and they were willing to carry out any additional duties.

Is the service well-led?

During our inspection of Premier Healthcare Solutions we saw evidence to support our judgment that the service was well-led.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time of this inspection. We have advised the provider of what they need to do to remove the individual's name from our register.

A new manager was appointed in May 2014 and we discussed with the provider and the acting manager the timescale for submitting a registered manager application.

At the time of our inspection the new manager was in the process of developing a quality assurance system. However, we saw they had already started to act on people's comments. Staff gave feedback to the manager about any concerns or comments made by people during their visits. The manager analysed the 'on call' log to monitor the service being provided out of hours. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities and demonstrated a good understanding of the ethos of the service. This helped to ensure people received a good quality service at all times.

We found peoples' views and experiences had been taken into account in the way the service was provided and delivered in relation to their care.

People's privacy and dignity was respected and people experienced care, treatment and support that met their needs and protected their rights.

We found that people who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse happening.

We saw there were appropriate checks undertaken before staff commenced work for the service.

We saw that an on-going training programme was in place and that staff were supported in their work.