Premium Care Solutions Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support

achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment this was not rated. Previously rated Good 2018. At this assessment the

rating has been rated as Good.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Assessments were carried out before recruitment of staff, this helped to ensure people's needs would be met appropriately. People told us they were involved in their assessments which were reviewed regularly or when changes occurred.

Staff told us people's needs were recorded in their care plans with all the information they needed to support safe and effective delivery of care.

The registered manger told us that they work closely with people and their relatives such as with client visits and regular interactions with care managers, to ensure care is kept tailored to each person's needs and preferences.

The service used clinical assessment tools such as the Waterlow score to assess people's risk relating to pressure area care. However, we found that these assessments lacked sufficient guidance regarding the actions required at different scoring thresholds. We discussed this with the registered manager who assured us this would be added and shared with the tea.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People were supported to remain as independent as possible and to develop independent living skills where appropriate. Staff encouraged and supported people to maintain existing employment and supported transitions into educational environments. Staff understood that promoting independence was a key part of their role.

Staff had received specific clinical training aligned with the needs of the person they were supporting. This included tracheostomy care and Percutaneous Endoscopic Gastrostomy (PEG) feeding. Staff were able to describe how they applied good practice into their daily routines.

Care plans were informative and reflected individual needs. The registered manager gave examples of how they remained up to date with current legislation and guidance.

People mainly told us they felt staff were trained to meet their needs. One person told us, "They have a long training period. If the carer isn’t comfortable, they won’t get signed off. (Relative) has a tracheostomy and they aren’t signed off until they can do it. They shadow the older carers." Another said, "The new carers that come in are buddied up. They have a lot of training before they start their shifts. They have specific training for spinal injuries. They are not left on their own until they are signed off." However, one person told us, "I don’t know what training they have. I don’t know if they are trained in manual handling or drug administration. I feel I have trained them myself."

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People and their relatives' mainly spoke positively about the staff and mainly told us they were confident that people knew their needs well. One person told us "The majority of my team I have had for a good few years. It becomes a routine, so they know exactly what to look out for. They pick things up pretty quickly if not right." Another person told us, "I don’t know what training they have. I don’t know if they are trained in manual handling or drug administration. I feel I have trained them myself."

Staff mainly told us they felt supported and that this had improved over the past year. They told us there was good communication within their team of supporting their individual, with handovers at the start of each shift and they had regular team meetings which again had increased recently. The staff we spoke with had good knowledge of the people they support.

We saw evidence of multi-disciplinary meetings and working with other agencies to support someone with a transition to a new care provider. There was evidence of daily records in people's care plans.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff monitored people and recorded on daily notes within their electronic care system. Staff we spoke with were able to demonstrate what they were monitoring and why with some giving examples of actions that had been taken when concerns had been identified.

There was a system in place to monitor people's health and well-being. However, some records required more details regarding when and what actions were needed to be taken, this was discussed with the registered manager who assured us further information would be added.

People's care plans contained information about their health conditions. This helped to ensure staff knew how to safely care for people and their needs.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Peoples care plans contained peoples individualised expectations and goals. However the service lacked a structured monitoring tool to track progress for example people had recorded future plans and aspirations as improving their walking and to move nearer to family, we saw no evidence of how this is being monitored and how they are being supported to achieve this. The registered manager told us this is currently reviewed through weekly reports and client visits.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People's care plans contained information regarding capacity and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR).

People had best interests’ decisions in place where necessary. However further details were needed to demonstrate the extent of relatives’ level of involvement in these decisions, this was discussed with the registered manager who assured us additional information would be added.

Staff had received mental capacity training and gave good examples of what this meant in their working days, they also provided good examples of how they gain and respect people's consent, helping to ensure people they support are involved in decisions about their care and treatment.