Premium Care Solutions Limited

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them

with compassion, kindness, dignity and respect.

At our last assessment we did not rate this key question. Previous inspection 2018 this was

rated as Good. At this assessment the rating has remained Good.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

People and their relatives told us they were treated with kindness. One person told us, "I have had them for quite a long time. We get on well and I find they are good at their job. My team is pretty strong. "Another person told us, “It is not just a job to them. They are recruited because they have a certain nature. They are compassionate with (relative). They know when (relative) needs space."

The staff we spoke with knew the people they supported well, they knew their life stories, what their likes and dislikes were. However, some staff did speak of previous times where kindness was not consistently upheld by some members of staff, this was reported to the management team. The management team took action to address these issues this demonstrated commitment to maintaining high standards of care and accountability.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities,

aspirations, culture and unique backgrounds and protected characteristics.

People and their relatives told us their staff team knew their likes and dislikes. One person told us,"(relative) is nonverbal so they have to pick up on facial expressions. They know when (relative) is not quite right. They are respectful of our ways in our home."

People’s assessment and support plans contained information about their unique backgrounds and the things important to them. However, we noted some care plans were incomplete. For example, a person's care plan we reviewed had a blank section under the area "how I would describe myself “, with no explanation provided.

Staff knew people well and knew what was important to them. We were given examples of people being supported with their cultural, religious and social needs. For example, attending religious places of worship, and receiving culturally preferred meals.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

People and their relatives told us they were supported to remain as independent as possible and were supported with their hobbies and interests. One person told us, "They support me to take (relative) out on trips so they can access other things like other people. They take (relative) to holiday club. "Another person told us “They try and give (relative) choices. (Relative) has a communication device which they have had to learn to use. (Relative) uses an eye gaze. In the holidays they take (relative) to the theatre, cinema, they look into activities. They found a local disco for people with learning difficulties and asked if they could take (relative).” However, another person told us, "I would like to know what training they have, I don’t know if it is relevant. I don’t know if they could have had eye gaze training which would have taken the strain off me."

Care plans contain peoples likes and dislikes and their hobbies, we saw evidence of the provider working collaboratively with people, their families and external professionals to support a person who wished to embark on a personal relationship. This demonstrated commitment to respecting people's rights to intimacy and companionship.

Staff had built positive and caring relationships with people they supported and their family members. This helped them deliver person centred care and meet people’s individual needs. Staff understood people’s routines and what they liked. Staff promoted people’s independence and encouraged them to do as much as possible for themselves.

People chose what time they got up and went to bed, what they wanted to eat and how they would like to spend their day.

The provider listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

People and their relatives mainly told us they were happy with how their needs were responded to. One person told us, "Medically yes. However, some of (relatives) behaviours can be quite extreme as (relative) has neurodivergence. It can be difficult to meet those needs. Recently it has been better." Another person told us, "They would let me know. (Relative) has epilepsy. They keep me informed if (relative) has any extra medication. (Relative) has pressure sores that they treat and bleeding gums.”

People received care from a consistent team of care staff specifically recruited for them, which enabled staff to build a strong relationship and recognize changes in health and wellbeing.

Staff gave good examples of responding to health needs, including where they had identified and supported a person with a blocked tracheostomy. Their ability to recognize and respond to changes in the person they support demonstrated attentiveness and understanding of the person.

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff mainly told us they felt supported by the management team, several noting they felt more supported within this past year. Staff told us they felt able to raise any concerns.

Staff had team meetings via Microsoft Teams and were mainly confident to speak up. However, some staff reported that when they had previously spoken up, their concerns were shared with the person they were supporting. This was raised with the management team, but staff told us they did not receive any feedback. As a result, some no longer feel confident speaking openly during team meetings.

Whilst rota’s and carer notes did not evidence staff breaks, most of the staff we spoke with assured us they took breaks according to the person’s needs and plans for the day.

The provider had a lone worker policy in place, supporting staff working independently and helping to ensure their safety.

Most staff told us there were adequate facilities for them to shower, store food and to eat. Some staff who supported waking and sleeping nights reported facilities were not always adequate. Some staff told us they were only allowed to use the bathroom within the person they were supporting's living area, with access only through the person’s bedroom, which was disturbing to the person during the night. They had reported this back to management but were unsure of any action they had taken.

Some staff told us when they are needed to call in sick, they had been told to find cover for their shift through the staff group chat. This approach places undue pressure on staff, potentially impacting on staff well-being.