Premier Community Also known as Premier Nursing Agency Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated good.This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice. The provider embedded a learning culture in the service. Staff were aware of procedures to follow to report and record incidents. We saw accidents and incidents were reviewed and analysed to identify themes and trends.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

We saw evidence in care plans of referrals to health professionals and information was shared and reviewed to ensure people’s needs were met. There were systems in place for staff to follow to raise any issue, concerns or changes in people’s need. This ensured people’s safety was managed effectively.

People felt involved in their care and relatives felt staff engaged with them and other professionals when needed. One person said, “I had an initial assessment, and staff maintain my independence.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. The registered manager shared concerns quickly and appropriately. Staff understood safeguarding procedures and reported incidents immediately to management.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People's capacity was assessed in line with MCA and decisions were made, where people did not have capacity, in their best interest.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive, and enabled people to do the things which mattered to them. Risks associated with people's care were identified and managed effectively.

People and their relatives felt staff understood people’s needs and managed risks to their safety. Staff received appropriate training and competency assessments to ensure peoples risks were manged safely. One person said, “The carers know me very well, I feel very safe.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Appropriate checks of the environment were carried out for each person they supported. Appropriate risk assessments were in place for staff to follow.

The provider did not always make sure there were enough staff. However staff were qualified, skilled, and experienced, who received effective support, supervision, and development. They worked together well to provide safe care which met people’s individual needs. Members of staff were recruited safely and there were sufficient staff to meet people’s care and support needs.

People told us staff stayed for the full duration of visits, and had the experience and training needed to support them safely and effectively. However, some people raised concerns staff were very rushed and did not always arrive on time. They could not fault the care received during the call. People thought it was due to staff shortages. One person said, “I am more than happy with the carers, but they are very rushed, short staffed, have more on their schedules than they should have. More recently there has not been a full allocation of staff I feel.” We discussed this with the registered manager; they explained 1 area had been short staffed. They were recruiting but still had checks to complete. They told us in these areas they had put a temporary suspension on new clients until the staffing was in place.

Staffing rotas were developed to ensure people received the commissioned calls and care was provided in line with people’s care plans. Most staff told us there was adequate numbers of staff to ensure all visits were carried out and to ensure they stayed for the correct time allocated. However, some staff told us they felt very rushed, had very little or no travel time between visits and, as such, visits got later as the day progressed. The registered manager assured us this was being addressed by recruitment of new staff.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had access to appropriate stores of personal protective equipment (PPE). Members of staff had access to infection prevention and control policies and received appropriate training and spot checks to ensure infection control procedures were followed.

A person said, “I spilt a hot drink on my legs, carers were excellent at keeping it clean and sterile, they did brilliantly. The district nurse only visited once as they were happy with the care. Staff always wear PPE.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff involved people in planning, including when changes happened.

Administration of medications was managed safely. Members of staff had access to policies and procedures which supported safe practice. Staff were knowledgeable on peoples’ medicines and specific requirements. Staff were trained and received competency checks. People who received support from staff with medicines management, all told us they received medicines safely. A person said, “My medication is given from blister packs correctly, all very good. I have no concerns.”