Prime Care Domiciliary Ltd

Prime Care Domiciliary Limited is a domiciliary care service providing personal care and support for people in their own homes. The service provides support to older people and younger adults with a range of needs including physical disabilities and sensory. At the time of the inspection, there were 4 people using the service.

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

People were receiving an improved service following the last inspection. People were safe due to improved recruitment practices which ensured that appropriate and suitably skilled staff supported them. Risks to people had been assessed and mitigated through guidance for staff. We have made a recommendation about the completion of more specific environmental assessments. People were supported by enough staff to keep them safe and provide effective care. People who required help with their medicines were supported safely. People were protected from harm by staff who understood safeguarding principles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were supported by staff who now received a formal induction with training that was appropriate for their role. People were supported with their eating and drinking needs by staff.

People told us that staff were kind and caring. Staff sought people’s views and involved them in decisions about their care. People were treated with dignity and respect.

People received a responsive service where their care was arranged according to their needs and wishes. Staff knew these needs well. Staff were flexible and adapted to peoples’ request to adjust their support. People received good continuity of care and received care at times that suited them. The management dealt with issues well and people felt confident that complaints would be dealt with appropriately by the registered manager.

The registered manager was well regarded. The registered manager had improved quality assurance systems and oversight of people’s care and information was used to drive service improvements. People, their relatives and staff were asked for their feedback and their opinions were respected and acted upon.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 27 December 2018)

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 inspection was prompted by a review of the information we held about this service. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Prime Care Domiciliary Limited is a domiciliary care agency. It provides personal care to people living in their own homes. It can provide a service to older people and younger adults. At the time of the inspection there was only one person who received the regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, which includes help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service was registered in September 2017 and is the only service owned by the provider. The management team consisted of two providers, one of which was the registered manager. A registered manager is a ‘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.

Not all risks to the person’s safety had been considered or mitigated sufficiently. Recruitment practices were not robust. The registered manager did not work in accordance with their own policies and procedures or legislative requirements. They had not taken appropriate measures to ensure that staff were suitable to work with the person before they began work. This was an area of concern.

There was a lack of oversight and quality assurance audits. Shortfalls that were identified as part of the inspection had not been picked up on acted-upon by the registered manager. This related to the lack of safe practices when recruiting staff as well as the insufficient monitoring and supervision of staff. The management of medicines, the lack of involvement of the person in decisions that affected their care and the lack of reviews to ensure guidance for staff was current, were also issues that had been identified as part of the inspection. There was a lack of understanding about the Mental Capacity Act 2005 (MCA) and how the person should be supported in accordance with this. Quality assurance surveys did not gather sufficient information to provide the registered manager with the person’s feedback on the service they received. The lack of oversight did not enable the registered manager to learn from situations to ensure that they continually improved the service. These were areas of concern.

The person told us that they were involved in day-to-day decisions and that staff provided them with choice. However, the registered manager and staff had not always ensured that the person was involved in their care. Decisions had been made by others and these had sometimes conflicted with the person’s own wishes. The person was not supported to have maximum choice and control of their life. Staff did not support them in the least restrictive way possible; the policies and systems at the service did not support this practice.

Staff knew how to keep the person safe. They had undertaken training and knew what to do if there were concerns about the person’s safety. There were sufficient staff to ensure the person’s needs were met. Risk to the person and their environment had been considered. Staff were provided with personal protective equipment to ensure that infection control was maintained.

The person’s needs had been assessed before they had started to use the service. Staff were provided with guidance as to how to meet the person’s needs.

The person told us that staff supported them to prepare meals and that their choice was respected. Staff had liaised with the person’s relative if they were concerned about the person. This enabled them to have access to external healthcare professionals to maintain their health.

The person told us that staff were, “Very good”. They told us that the staff were kind and caring. They told us, “They stay as long as they need to. One of the things I like is that you can talk to them. I know about their families and they know about mine. It is nice to have the same people coming rather than different people”.

The person told us that the staff were mindful of their privacy and supported them in a sensitive way. They were complimentary about how staff supported them to remain independent.

The person was provided with information about how to make a complaint. They told us that they had not had reason to complain but knew that their relatives would contact the registered manager if they had concerns.

This is the first time that the service has been inspected. They have received a rating of Requires Improvement for the first time. We found two 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. Full information about CQC’s regulatory response to the more serious concerns found during this inspection will be added to the inspection report after any representations and appeals have been concluded.