Archived: Prime Care Community Services Limited - Hampshire

An inspector carried out an inspection on 12 November 2014. There is no registered manager for this service. The recently appointed manager has applied to be registered with the Commission. We spoke with the manager during this inspection, as well as a senior carer and an administrator.

We spoke with people who commissioned services from this provider and they told us that the quality of care and management of the service had improved and they were ready to purchase new packages of care from them once the Commission lifted the condition imposed.

We spoke with two staff on the telephone who told us how good the agency was and they showed a good knowledge and understanding of the people they provided care to. They were aware of the need to ensure people consented to their care and treatment and what to do if someone lacks the mental capacity to consent to their care. They also told us the provider had made improvements to the scheduling of care calls since our last inspection. They told us this was working well.

We looked at the results the provider had received back of a mini-survey sent out to people who used the service. The manager said they had undertaken this survey to test out people's views of the recent changes to the running of the service. Of 36 surveys which had been sent out, 16 were returned with more expected. The responses seen were mostly positive about staff and the care received.

We carried out a follow up inspection to check action had been taken in areas where the service was not meeting minimum standards at our last inspection in March 2014. We also looked at issues that had been brought to our attention anonymously.

We also used this inspection to answer our five questions. Is the service safe, is it effective, is it caring, is it responsive and is it well led?

At the time of our inspection the agency was providing care and support to 63 people. We spoke with eight of them and also two relatives in order to understand the service from their point of view. We looked at records and files. We also spoke with the manager, the area manager and seven members of staff.

This is a summary of what people told us and what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the Service Safe?

People we spoke with and relatives said they were satisfied with the standard of care received from the agency. Everyone told us they felt safe with the people who provide care to them. All of the people we spoke with were positive about the people who supported them. Comments included , 'I am happy with the staff who come to support me'. Another person said' I am always treated well'.

We found the service had systems in place to ensure people were protected from abuse, or the risk of abuse. Staff had an understanding of safeguarding issues and how to report abuse or allegations of abuse.

CQC monitors the operation of the Mental Capacity Act 2005. The manager at Prime Care Community Services Limited ' Hampshire had an understanding of the Mental Capacity Act 2005 and their responsibilities. However, where people lacked capacity they were not always protected because the provider did not always follow the appropriate guidance and code of practice.

Is the service effective?

Staff we spoke with said they were aware of people's needs and how they preferred to have their care delivered. Staff said they got on well with the people they supported.

People who used the service told us that they were satisfied with the care and support they received. One person told us. 'They talk to me, never rush me and always ask me what I want them to do.' However people said that they did not always get the same carer at each visit and said sometimes carers arrived late.

Is the Service caring?

People we spoke with all said the staff were kind and caring and that they were treated well. People were positive about the people who supported them. Comments included , 'the staff are very attentive and help me with whatever I need' and 'the girls are kind and go out of their way to help'.

Is the service responsive?

People's care plans took into account information about people's needs and preferences. The manager told us that there were individual care and support reviews carried out every three months and we saw records to support this. The manager or a senior carer visited people in their homes and checked with them how the service was meeting their needs. We saw completed review forms in people's care folders.

Systems were in place to regularly assess and monitor the quality of the service provided. Risks were assessed and appropriate action plans were in place. There were processes in place to review and learn from incidents, accidents and complaints

Is the service well- led?

People we spoke with said that they knew how to contact the office if they needed to and they were given a number to contact if they had issues outside office hours. However two people told us that they had experienced difficulty contacting the out of hours service, especially at weekends.

We spoke with the manager and seven members of staff. They all told us they were well supported by management. They told us training was good and they were provided with the information they needed to support people effectively.

We were told that, 'Lots of changes are happening for the best,' and that, 'Prime Care do a really good job'.

We found that there were policies and procedures in place for staff to use to assist them to provide safe and effective care in supporting people in line with their needs and wishes. For example, we found that the service had a medicines policy in place which was followed in practice and staff were provided with sufficient information to support people with their medicines safely.

We were told that a new consent to care and treatment form had been introduced. However, we found that there was a lack of understanding with regards to the use of best interest decisions for people who were not able to make informed decisions about their care.

The service had systems in place to ensure people were protected from abuse, or the risk of abuse, and that their rights were respected and upheld. Staff had an understanding of safeguarding issues and how to report abuse or allegations of abuse.

We found that effective systems were in place to ensure staff were appropriately supported to enable them to deliver care and treatment safely.

We found that the service did not have effective monitoring processes in place to help regularly assess and monitor the quality of the service being provided.

We spoke to four care staff, the registered manager, a trainer and the manager from another Prime Care Community Services agency who was supporting the registered manager.

Staff told us about some of the improvements that had been made regarding the storage and administration of people's medicines. However, the training being provided was inconmsistent with the new arrangements and one staff member said the ways of communicating changes was sometimes "Overwhelming and confusing".

People told us that they were generally satisfied with the care they received and that "On the whole the carers are very good." However, several people commented on a lack of continuity of care staff and poor time keeping which had got worse over the last few weeks. People also told us there had also been a shortage of staff recently.

The care files we looked at were detailed and up to date and overall the records reflected that staff were kind and caring and often went over and above their remit to make sure people were well cared for.

Other records we looked at were not up to date and accurate including those relating to training, medicines management and mental capacity. We raised serious concerns about the medicines management and the training and have also asked for improvements to the quality monitoring systems.

We found that staff delivered care in line with people's needs and preferences and with their consent. We looked at care plans and records and found that people's care and support was planned and delivered to meet their needs safely.

Training records we looked at showed staff had received appropriate training to enable them to carry out their duties safely.

We found the provider had good systems in place to ensure staff delivered care competently and safely. A person told us they were " very happy" with the skill level of staff providing their care.

We looked at the providers system for dealing with comments and complaints. We found that people were made aware of the complaints procedure and that complaints were investigated and responded to appropriately.