Background to this inspection
Updated
17 April 2021
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by one inspector and two experts 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
Prestigious Homecare is a domiciliary care agency, which provides personal care to people living in their own homes. 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. However, at the time of our inspection, the service was overseen by the late provider’s personal representative. The personal representative was in the process of applying to register the service as a limited company.
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.
Inspection activity started on 15 February 2021 and ended on 5 March 2021. We visited the office location on 17 February 2021 and the 3 March 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The service was not asked to complete a PIR (provider information return) prior to this inspection. This is information we require services to send us to give some key information about the service, what the service does well and improvements they plan to make. We took into account that we did not ask for the PIR when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 19 people using the service and five relatives to get their views on the service. We spoke with the registered manager, the provider’s personal representative, two care co-ordinators, a senior/trainer, and five care workers.
We reviewed a range of records. This included four people’s care records and a sample of medicines records. We also looked at a variety of records relating to the management of the service including policies and procedures and infection control documentation.
After the inspection
We continued to seek clarification from the service to validate evidence found.
Updated
17 April 2021
About the service
Prestigious Homecare is a domiciliary care service based in Wigston, Leicestershire. It provides care and support to people living in their own homes. At the time of our inspection there were 82 people using the service who received personal care.
The Care Quality Commission (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
The service did not have a system in place to assess, monitor and improve the quality and safety of the service provided. This meant shortfalls within the service had not always been identified.
The service had not notified CQC in a timely manner of significant changes to the way the service was organised. This meant the service continued to provide regulated activities when they were not registered to do so.
Improvements were needed to way risk was assessed at the service. Staff did not always have the information they needed to protect people from risk.
People’s medicines were not always managed safely. Some records were incomplete, and there was no audit system to check if medicines had been correctly administered.
Not all staff had had the training they needed to prevent and control infection. The service had a good supply of personal protective equipment including gloves, masks and aprons but staff hadn’t always worn this in accordance with government guidance.
The registered manager was working to an action plan with a view to improving the quality of the service. Staff competency checks had been carried out, staff training booked, and staff files improved.
People and relatives thought the service was safe and the staff caring and kind. The registered manager was supportive of the staff and dedicated to the well-being of the people using the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This was a focused inspection based on concerns we had received about the service. These were in relation to people's safety and the governance of the service. As a result, we undertook this focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed. This is based on the findings at this inspection.
Rating at last inspection
The last rating for this service was Good (published 1 November 2018). At this inspection the provider was in breach of a regulation and the overall rating for the service is now Inadequate. This is based on the findings at this inspection.
You can see what action we have asked the service to take at the end of this full report. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Prestigious Homecare on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the service to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.