Archived: Premier Care Limited - Cheshire Branch

Premier care is a care agency, providing personal care and support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. At the time of this inspection the agency were providing personal care to approximately 181 people in Warrington and St Helens.

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

People told us they felt safe when being supported by the staff. People told us staff had enough time to support them and were usually on time. Staff were aware of what might be a safeguarding concern and how they would raise this. Risk assessments ensured people were supported to manage the risks in their daily lives. Staff followed good practice in relation to the safe management of medicines.

The provider completed assessments of people's needs and staff said they had enough information to support people effectively. People told us staff usually knew how to support them, but it could take time with newer staff. The provider ensured new staff had induction training which included shadowing more experienced staff. Staff said they had received adequate training and supervision.

People told us staff were caring, kind and polite. People who needed support with showering or bathing told us staff were respectful and put them at ease. People said they felt able to express their views and had been involved in making decisions about their care.

The service completed regular reviews of people's care needs and preferences and amended their care plans to reflect any changes. People told us they had been involved in reviews of their care. People were aware of the provider’s complaints policy and said they felt able to raise their concerns.

Staff said they felt the service was managed well and management were on top of everything. Staff said the management team provided positive feedback. Staff told us they felt proud to be working for the service. People told us they were able to raise anything with the management team. We had mixed responses from some people we spoke with who felt the management could be more understanding. Most people were aware there had been a significant change in the size of the agency and had felt this had affected how well organised the agency had been; but said things had improved in recent months. Effective monitoring of visits and care quality ensured the service maintained the standard of care expected.

Rating at last inspection (and update)

At the last inspection this service was rated as Requires Improvement with two breaches of the regulations in relation to; safe care and treatment and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

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.

There was a registered manager in post at the time of our inspection. 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.

This was the service’s first published inspection since it was registered at this address. At this inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Systems in place to monitor the quality of the service were not always effective at identifying and rectifying concerns or changes.

Staff did not always have enough training or knowledge to know how to support people with some specific health conditions.

Guidance was not always available for staff to follow in relations to people’s specific conditions, such as diabetes, epilepsy, stoma and catheter care. There was also a lack of information about how to support people with behaviours that challenge.

There was mixed feedback about staffing and the punctuality of calls.

People’s medicines were not always managed safely as there were not always instructions available for staff to follow.

The principles of the Mental Capacity Act 2005 (MCA) were not always followed as mental capacity assessments were of varying quality and had not always been reviewed as appropriate. People told us they were asked for their consent prior to being supported.

Care plans and risk assessments were not always updated when necessary and reviews had not always identified omissions.

Lessons were learned as action plans were put in place following feedback from an external consultant about what improvements were required. However action had not always been completed or embedded.

People were supported to have food and drink where necessary. We have made a recommendation about how staff record the support they provide.

People told us they felt safe. People were protected from avoidable harm by staff who understood their responsibilities and had been recruited safely.

Infection control measures were in place as people told us staff took appropriate measures.

People were supported to access other health professionals where necessary, or their relatives were kept updated.

The service checked whether they could support someone prior to the care starting by reviewing information provided to them.

People felt they were treated with dignity and respect. People were involved in decisions about their care and were encouraged to be as independent as possible.

People knew how to complain and felt able to raised concerns. Concerns had been responded to.

The service had made preparations for end of life support, although they did not currently support any one who was nearing the end of their life.

People, relatives and staff found the registered manager and providers to be approachable.

The provider had made us aware that they knew of some of the concerns and were in the process of developing and implementing a new care plan and some technological advancements to improve the service.

Notifications were submitted as required.