Archived: Premier Care - South Lancashire Branch

Updated 23 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 13 September 2018 and was announced. We gave the service short notice of the inspection so that the manager would be available to assist us. Two adult social care inspectors completed the inspection.

As part of our inspection planning, we looked at a wide range of information we held about the service. This included information about any statutory notifications the provider is required to send to us by law, feedback about the service and any investigations undertaken. We used the information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. Due to technical problems, the provider was not able to complete a Provider Information Return. We took this into account when we inspected the service and made the judgements in this report. We used a planning tool to collate all this evidence and information prior to visiting the agency office.

To understand people’s experiences who used the service we spoke with four people currently in receipt of care from the service and one relative. We also spoke with three members of the staff, the regional manager, one of the directors of the company and the manager who had overall responsibility for the operation and oversight of the service. We looked at four full care files and a further four care files in relation to medicines management for people currently in receipt of care. We also reviewed three staff files, training and supervision records, audits, quality monitoring and the operation and oversight of the service.

Updated 23 October 2018

This comprehensive inspection took place on 13 September 2018 and was announced. This meant the provider was given short notice of the inspection. This was so the manager would be available to assist us with the inspection process.

The service was last inspected on the 29 December and 2017 and 4 January 2018, when it was rated as inadequate in the area of safe and requires improvement in the areas of effective, responsive and well led. The area of caring was rated good at that time. This meant that the service was requires improvement overall. At the time of our last inspection a new provider had very recently taken over the service and the service has been renamed to Premier Care South Lancashire Branch since our last inspection.

At that inspection we found the management of medicines unsatisfactory. A basic medicine audit had been introduced, but this was ineffective, as it only focused on missing signatures on the Medication Administration Records (MAR) and therefore other shortfalls around medicines management had not been identified. This was a continued breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment. We also identified that risks had not been managed within a risk management framework and therefore people could have potentially been at risk of harm. This was a further breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 for Safe care and treatment.

We also found a breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Person-centered care, because people were at risk of receiving inappropriate or unsafe care and treatment. The recruitment practices adopted by the service were not sufficiently robust to ensure that all employees were fit to work with vulnerable people. Relevant checks had not been completed in a timely manner and there was no evidence to demonstrate that police checks had been conducted. This was a breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Fit and proper persons employed. Systems and processes had not been sufficiently established to ensure compliance with the requirements. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good governance.

Following the last inspection, we asked the provider to complete an action plan to show us what they would do and by when to improve the key questions of safe, effective, caring and well led to at least good. Since our last inspection the new provider had taken over the service and had made a number of changes in relation to the operation, management and oversight of the service. During this inspection, we found the service was meeting the requirements of the current legislation.

Premier Care South Lancashire Branch is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, people with a physical disability and or sensory impairment. At the time of our inspection 82 people were registered with the location. However, not everyone using Premier Care South Lancashire Branch received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where people receive this element of care we also take into account any wider social care provided. The manager told us 23 people were receiving personal care support as part of their registration.

At the time of the inspection the service did not have a registered manager in post. There was a manager who had submitted a registered managers application to the Care Quality Commission. Prior to the publication of the report the manager became registered with the Care Quality Commission. 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 was run.

People told us they were happy with how their medicines were managed. Whilst improvements were noted in the way medicines were managed we saw some gaps in the medicine records. The provider took immediate action to investigate this.

People told us they felt safe receiving care from the service. Staff knew what to do if abuse was suspected and had received safeguarding training.

Safe recruitment procedures had been established and staff rotas provided clear information about the visits staff were to undertake. We received positive feedback about the knowledge and skills of the staff team. Staff told us the training provided by the service supported them in their role.

Care records we looked at had evidence of written consent. People told us their care had been discussed and agreed with them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Care records contained information about health professionals involved in people’s care. People we spoke with were very happy with care they received from the service. It was clear from the comments that staff treated people with dignity and respect at all times.

Improvements had been made to the care records which demonstrated what people’s individual needs were and how these could be met. Technology was used to good effect for the benefit of the service provided to people.

Systems to deal with complaints were in place and people we spoke with told us they knew how to complain. We received very positive feedback about the improvements since the new company took over the service. Team meetings were held and we saw minutes that demonstrated the topics discussed.

Audits and quality monitoring was taking place. This demonstrated that the service was run effectively.