10 & 15 December 2015
During a routine inspection
We carried out an announced inspection of Prestige Nursing – Liverpool on 10 & 15 December 2015. The inspection was announced to ensure that staff were available to support the process.
Prestige Nursing - Liverpool provides personal care and support with domestic tasks to people living in the community. It also provides nursing staff to health and social care settings.
At the time of the inspection a registered manager was not in post. The manager was in the process of registering. 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.
We asked people about the safety of services. Each of the people that we spoke with told us they felt the service they received was safe. The provider had delivered an extensive training programme for staff and managers regarding adult safeguarding. The provider had a range of systems and procedures in place which allowed people using the services, their relatives and staff to raise any concerns. Evidence of these systems was made available during the inspection.
The care files that we saw showed clear evidence risk had been assessed and reviewed regularly. The risk assessment processes were sufficiently detailed and robust.
Incidents and accidents were subject to a formal review process which included a meeting with any staff involved and an analysis that was shared with the manager.
Staff were recruited following an extensive process which included individual interviews and shadow shifts [working alongside an experienced colleague]. Each offer of employment was made subject to the receipt of two satisfactory references and a Disclosure and Barring Service (DBS) check.
Medicines were stored in people’s homes and administered safely with staff support.
Staff had been recruited and trained to ensure that they had the rights skills and experience to meet people’s needs. Staff were supported by the organisation through regular supervision and appraisal.
The organisation promoted effective communication with staff and people using services through the completion of daily records, regular supervision and appraisal.
Staff demonstrated that they understood the key principles of the Mental Capacity Act 2005 (MCA) and delivered care and support in accordance with the act.
People were supported to eat and drink in accordance with their individual care plans. In some cases these plans had been developed with the input of a dietician. The organisation also employed a specialist nurse to offer advice if required. Records of food and fluid intake were recorded in daily notes.
We saw that people were supported to maintain good health through regular contact and review with a range of healthcare professionals. The organisation maintained effective links with district nurses and was involved in the review process.
People told us that they were treated with kindness and respect by staff.
The staff we spoke with knew the people that they cared for and their needs in appropriate detail. Staff told us they had sufficient time to focus on the person and not the task.
The records we saw showed that people were actively involved in making decisions about their care. Their views were recorded and considered as part of the review process by staff and healthcare professionals. People were given choice in the delivery of care and their independence was maintained and promoted appropriately.
We saw that people were actively involved in the assessment process and the planning of care. Care was also reviewed as part of the staff supervision process and the analysis of incidents.
People were encouraged to follow their interests and hobbies by staff.
People were given choice about the gender of their care staff and the times when staff provided care.
All of the people we spoke with understood how to complain if they needed to, but none of them had registered a formal complaint. People were encouraged to provide feedback to the organisation through informal and formal mechanisms.
At the time of the inspection there was no registered manager in place. The manager was in the process of registering with the commission.
The manager and supervisors were clearly aware of the day to day culture and issues within the service. We saw that they knew the people using the service and their staff well.
Staff were motivated to provide high quality care and understood what was expected of them. They spoke with enthusiasm about the people they supported and their job roles.
The organisation had a robust approach to the monitoring of quality at a local and national level. Systems included; spot checks, care file audits, telephone calls to people using the service and general audits.