We carried out a review of the data available to us about Premiere Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Premiere Care, you can give feedback on this service.
Premiere Care is a domiciliary care agency, providing care and support to people living with physical disabilities, or dementia and older people. At the time of this inspection, there were 55 people using the agency.
The agency can provide a practical and/or a personal care service, during the day or night. The agency mostly provides support to people in and around the Yorkshire Dales; it introduces self-employed care workers to the people it supports. The provider has ongoing direction and control of the care provided and is responsible for the safety and quality of the agency. The management team (care coordinators and registered manager) are employed by the provider.
Not everyone who used the agency received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
People benefited from improved quality assurance processes within the agency. The provider had made positive changes to the way they assessed, monitored and reduced risk to people’s health and safety. The management team carried out regular reviews and spot checks to ensure the quality of the agency, and the safety of people who used it, were maintained to a high standard.
Care plans and risk assessments had been reviewed; access to records and monitoring of the quality of care had improved. The introduction of an online care system meant that changes to records could be actioned straight away. The management team were able to monitor this daily and completed regular audits.
People confirmed they had a tailored package of care to meet their needs. Without exception, people said they felt safe and care workers were respectful.
People received their medicines safely and their health was well-managed. Improvements had been made to the monitoring and recording of medicines administered by care workers.
People received good consistent care from friendly care workers who went out of their way to assist them. Relatives and people said the agency was reliable and efficient. They had good communication with the office and received regular updated information during the Coronavirus pandemic.
People said their care workers were skilled and competent. Care workers had received appropriate induction, training and support to enable them to carry out their role.
People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible. The policies and systems in the agency supported this practice.
People, relatives and care workers told us the management team were approachable and listened to them when they had any concerns. All feedback was used to make improvements to the service.
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 agency was requires improvement (published 20 February 2020) and there were three breaches of regulation. At this inspection, we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this agency on 26 November 2019. Three breaches of legal requirement were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve medicine management, care worker training and supervision, records, and quality assurance as part of their governance of the agency.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe, Effective and Well-led, which contain those requirements.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care service inspections even if no concerns or risks have been identified. This is to provide assurance that the agency can respond to COVID-19 and other infection outbreaks effectively.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Premiere Care on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Premiere Care is a domiciliary care service providing personal care to people living with physical disabilities or dementia and older people. 50 people were receiving a service at the time of our inspection.
The service mostly provides care to people in and around the Yorkshire Dales. Some people had live-in care in their own homes 24 hours a day. Live-in care was provided to people across the country.
Premiere Care introduces self-employed care workers to the people it supports. Some staff were employed directly by the provider. The provider has ongoing direction and control of the care provided and is therefore responsible for the safety and quality of the service.
People’s experience of using this service and what we found
People were at risk due to poor governance and record keeping at the service. The provider did not understand regulatory requirements and had not met these. Their quality assurance systems were not robust or effective in identifying shortfalls. Records were not always completed or returned to the office in a timely way for monitoring. The provider introduced changes during the inspection to improve the situation. These changes had yet to be embedded and sustained. They were committed to providing high quality care and had plans to make further improvements.
People were at risk of harm due to poor medicines management. We could not be sure people had received their medicines safely as prescribed.
Safe recruitment records were not always completed. We made a recommendation about this.
Staff were not supported to carry out their roles effectively. Staff inductions were not recorded. Competency checks and spot checks were not completed to assess staff practice and monitor this.
People received support from regular care workers, who understood their care and support needs and provided effective care. 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. We made a recommendation about mental capacity records.
Staff formed meaningful caring relationships with people based on mutual respect and understanding. Staff provided kind, considerate care, respecting people’s equality and diversity needs, dignity and privacy.
People’s care was person-centred. Staff were knowledgeable about the people they supported, adapting their care to meet their changing needs and preferences. People and their relatives knew how to raise any concerns and trusted the provider to address these.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 26 November 2018 and this is the first inspection.
Why we inspected
This was a planned inspection based on when the service registered.
Enforcement
We have identified breaches in relation to staffing, good governance and failure to submit statutory notifications at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.