Archived: Prestige Nursing - Milton Keynes

The service did not have a registered manager in post. 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. A manager had been appointed at the service; they had submitted a registered manager application to the Care Quality Commission (CQC), which was in progress.

At the last inspection of the service on 13 November and 1December 2015 we asked the provider to take action to improve how they managed the recoding of medicines. The provider sent us an action plan telling us how they planned to improve. At this inspection we found the actions had been completed.

Staff knew how to recognise signs of abuse and what they needed to do to protect people from abuse.

Risks to individuals and the environment were identified and managed. Risk assessments were centred on the needs of the individual, to enable people to live as safely and independently as possible.

Staffing arrangements ensured there were sufficient numbers of staff available to meet people’s needs. The recruitment systems ensured that staff had the right mix of skills, knowledge and experience and were suitable to work with people using the service.

Staff were trained in the safe administration of medicines and where the service was responsible; people were supported to take their medicines safely.

Staff received regular training which provided them with the knowledge and skills to meet people’s needs. They also received regular supervision and support from senior care staff.

Staff sought people’s consent before providing any care and support. They were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation.

Where the service was responsible, people were supported to have a balanced diet that promoted healthy eating.

Staff met people’s day to day health needs and took appropriate action in response to changing health conditions.

People were treated with kindness and compassion and their privacy was respected. The staff understood and promoted the principles of person centred care.

People’s needs were assessed and their care plans had sufficient detail to reflect how they wanted to receive their care and support. People using the service and/or their relatives were involved in the care reviews.

Complaints were responded to appropriately and they were used as an opportunity for learning and improvement.

The registered manager understood their responsibilities. Their leadership style inspired the staff team to deliver a quality service. Staff at all levels understood the ethos and vision of the service.

Robust quality assurance systems were used to measure and review the delivery of care, and drive continuous improvement.

Two people told us that they were pleased with the level of care that they received. They also told us that most of their care was provided by a regular carer who understood their care needs. However, they told us that when their regular carer was unable to attend because of sickness or annual leave, they were happy with the care provided by the staff who covered their duties.

One relative told us that their family member had received a re-assessment of their care plan to make sure that their needs were being met by the staff. They also told us that they were happy to raise any complaints or concerns they had about the service with the provider and knew that these would be taken seriously.

We found that the service had made improvements to the arrangements for providing care to people and to the systems in place for supporting the staff. We also found that the service managed people's complaints effectively and made appropriate arrangements to ensure people gave their consent for their care. We found that the provider had a recruitment system that ensured that the staff were of good character before they started work.

The two relatives we spoke with told us that their family member's were usually well cared for by their regular carer who had a good understanding of how to meet their care needs. However, they told us that when their regular carer was on holiday, the level of care received was not at the usual standard. One relative of a young person told us that the agency provided staff cover when their regular carer was on holiday. However the care staff sometimes attended later than the agreed time and this meant that the care delivered was rushed. They also told us that on one occasion the care staff had forgotten to give their family member their breakfast. They told us that the late arrival of care staff impacted upon their family member's ability to get ready and attend school. Another relative told us that the staff who covered the shifts when their regular carer was on leave, did not have a good understanding of their family member's routines and the reasons why this was important for them to have this correct routine followed each day.