Prestige Nursing Sleaford

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 had a strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

Safety incidents were reported and investigated. Staff understood how to identify and report safety incidents and concerns. There was a culture of learning from events and people’s previous experiences to personalise and improve the service. One relative told us, “Prestige are very good at making sure my loved one is clean and supportive especially getting in and out of the shower. In the past my loved one had a bad experience and burnt themselves and refused to have a shower, when moving to Prestige the carers are aware of this and slowly have encouraged them to start having a shower.”

The registered manager was proactive at engaging with people and seeking feedback to identify learning and ways to improve the service. One person told us, “I know the manager. They are easy to talk to, open to listening and approachable.” One relative told us, “As a family we are very happy with the care, it is well run and I have spoken to the manager who is approachable and listens. I feel very fortunate my loved one is in the hands of Prestige Nursing.” The providers systems and processes supported a positive learning culture.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care.

People transferring their care to the service had a positive experience. The registered manager completed assessments with people to understand their needs and prepared care plans to ensure this information was clear to staff. One relative told us, “We have had 4 care agencies in the past, and Prestige Nursing are by far the best.”

The service worked effectively with other agencies to ensure care was delivered in a person-centred joined-up manner. One relative told us, “Prestige Nursing come twice a week to relieve the live in carer. The live in carer was involved in the care planning as they are heavily involved, and it was important that Prestige Nursing and the live in carer work well together in supporting and caring for my loved one. The process works really well, and everyone works together.”

Where people required support from health professionals, the care staff worked conjointly to ensure care people received the care they needed. One relative told us, “My loved one's health has deteriorated and their needs have changed. Prestige Nursing have been really good and supportive. Alongside the carers we have lung specialist nurses, community nurses, general practitioners, and staff from the hospice. Everyone is involved and work together."

Continuity of care was maintained through the provision of regular staff and organised care structures. One relative told us, “We have a team of 3 carers. My loved one knows them all. It’s great to have the continuity as it makes it easier for my loved one. They [staff] are all lovely and patient and know what to do and how to get the best out of my loved one.”

The provider worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People consistently reported they felt safe. One person told us, “I feel very safe in the company of the carers, they support me with personal care.” Another person told us, “I am safe, the carers know me well.”

People’s safety was supported by effective safeguarding procedures. This included effective systems for recording reporting, that promoted follow up action and learning. The providers safeguarding whistleblowing policies were up-to-date and effective. Staff understood how and when to access this information if required.

The registered manager was proactive at ensuring the safety of people using the service. For example, they completed regular check in phone calls with people and ensured they periodically visited people in their own homes to ensure they were safe and discuss any concerns.

The registered manager was also proactive at ensuring the safety of people in the wider community. For example, in response to events taking place in the local community, the registered manager had designated and publicised their office as a safe place for local citizens to go for refuge and support.

Care staff received safeguarding training and understood how to recognise and report concerns. Care staff were responsive to safety risks and supported the best interest of the people they supported. Care staff consistently told us they felt people were safe, and they felt comfortable raising concerns and management were responsive.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks related to people were assessed and managed appropriately. For example, risk assessments were used to understand and mitigate risks related to people’s care such as falls, use of medicines and skin integrity. This information was then used to inform care routines and people’s care plans. People’s risk assessments and care plans were reviewed periodically or when their needs changed. For example, one person’s mobility decreased following an admission to hospital. Risk assessments and care plans were updated to reflect their change of support needs.

People were involved in making decisions about their care and related risks. One person told us, “I am involved in planning my own care, and if my needs change, the care plan is reviewed. Someone comes from the office, and we discuss it together.”

People were supported to do the things that were important to them through positive risk management. For example, people were supported to engage in daily living tasks and access their community.

The provider detected potential risks and supported people to maintain a safe care environment at home. They made sure people’s equipment and technology supported the delivery of safe care.

The registered manager completed visits to people's homes to ensure environmental risks were minimised where possible to promote a safe supportive and working environment. Risk assessments were used where required to support environmental risk management. Where people used key-safes, staff ensured these were used correctly to promote people’s safety at home. One person told us, “In the evening, the carers tend to use the key-safe. Before they leave, they always make sure I have locked the back door, and they lock the front and put the key back in the key safe.”

Staff received training on how to use mobility equipment safely. This included both theory and practical training. Staff understood how to check equipment was clean and safe to use. People and their relatives told us staff were competent supporting people with their mobility equipment. One person told us, “I have an electric bath chair, and they [staff] help me get in and out of the bath. Without their [staff] help, I wouldn’t be able to have a bath.”

The provider made sure there were always enough qualified, skilled and experienced staff, who received thorough support, supervision and development opportunities. They worked together well to provide safe care that met people’s individual needs.

People were supported by well trained and competent staff who had good knowledge on how to meet the needs of the people they supported. Staff completed training relevant to people’s needs. Some staff required refresher training in relation to Dementia and Parkinsons, but they had good knowledge on how to meet people’s related needs and the registered manager actioned this during the assessment. Staff competence was assessed in certain areas such as delivering first aid and assisting people to move. One relative told us, “They [staff] are all well trained and know exactly what they [staff] are doing and how to handle my loved one, they are extremely good at motivating and encouraging.”

Staff were punctual and provided all required care. Feedback from people and their relatives was consistently positive. One relative told us, “The carer is well trained. They [staff] always turn up at the expected time. They [staff] provide lots of joy to my loved one and their support is invaluable”. Another relative told us, “The carers always stay the allocated time and turn up on time.” This was supported by feedback from a third relative who told us, “The time keeping is very good and my loved one does not feel rushed. I find Prestige Nursing are very flexible, approachable and responsive. They listen and always do their best to accommodate. I am confident in the carers’ ability. It is very reassuring to know my loved one is in safe hands. It is reassuring and relieves pressure as I know they will contact if there are any concerns.”

People were told who would be coming and when. One relative told us, “We are given a rota each week so we know who is coming on each call. If there are any changes due to staff illness, the office contact, and they will send another carer who has been before.” One person told us, “Every visit I look forward to, I receive the rota so I know who is coming. They [staff] are very caring and help me with a lot of things.”

Staff were recruited safely and the providers systems and processes supported the provision of suitably trained and supportive staff. For example, online trackers were used to ensure training compliance and prompt the registered manager when supervision or other staff engagements were due. Staff received regular supervisions and told us they felt well supported by leaders.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff understood how to maintain effective infection prevention and control (IPC) through the use of personal protective equipment (PPE) and by ensuring effective hand hygiene. The registered manager completed observations of staff which included IPC. One relative told us, “PPE; Gloves and aprons and foot coverings are worn at each visit.”

IPC was supported by the providers policy and procedures which were reviewed and up to date.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People were supported to receive their prescribed medicines in a timely manner. One person told us, “I need the carers, they help me with personal care, preparing my meals, administering my medication, I am dependant on the carers they help me remain in my own home, their time keeping is good.”

Where people administered their own medicines, care staff enabled and supported people to maintain their independence. “At first, I was reluctant to have carers as I have always been independent and didn’t want to lose that control. Having the carers hasn’t changed that, they help with what I can’t do, the rest I do myself. I take my own medication and make my meals and drinks.”

People's medicine records were well maintained and up to date. People’s care plans provided staff with guidance on how people liked to be supported with their medicines.

Staff received medicines training and completed a competency assessment before they supported people to administer their medicines. Staff described their training as useful and praised the support they received from the leaders.

The provider's systems and processes supported safe and effective medicines practices. Medicine quality audits were completed by the care planner to a high standard. These were effective at identifying gaps in administration records and prompted safe medicine practices. On 1 occasion, the medicine audit identified a medicine error an enabled mitigating action to be taken, demonstrating their effectiveness at keeping people safe. The registered manager worked closely with the care planner to maintain oversight of medicines quality audits.