Background to this inspection
Updated
17 April 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.
The inspection took place on 1 and 5 December 2017 and was announced. We gave notice of our inspection to ensure key people would be available at the service when we visited. The inspection team consisted of one inspector.
Prior to our visit we asked for a Provider Information Return (PIR). The PIR is information given to us by the provider. The PIR also provides us with key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with other information we held about the service. This included notifications we had received from the service. Services use notifications to tell us about important events relating to the regulated activities they provide.
We looked at the care records of four people, the recruitment and personnel records of 10 staff, training records, staff schedules and other records relating to the management of the service. We looked at a range of policies and procedures including, safeguarding, whistleblowing, mental capacity and complaints.
We spoke with two people on the phone that were supported by the service and three relatives. We tried to contact a further three relative’s by phone but we were not successful. We spoke with five care staff, the quality manager, the business manager and the registered manager. We tried to contact a further three staff by phone but we were not successful.
Twenty-three health and social care professionals were contacted in order to gain their views about the service. Four of them provided feedback about the service. We have included there comments in the main body of the report.
Updated
17 April 2018
The inspection was announced and took place on 1 and 5 December 2017. We gave the provider 48 hours’ notice of the inspection. We did this to ensure key staff would be available at the service. At the time of the inspection 40 people were receiving a nursing and personal care service from Prestige. It provided a service to children, disabled people, younger and older adults. Many people using the service had significant and ongoing healthcare needs.
There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.
Staff knew the signs of abuse and were confident to raise any concerns they had with the registered manager and provider. People and their representatives told us they were confident to raise any concerns they had with staff and that any concerns they had raised had been acted on. People had individual risk assessments so that staff had the information they needed to support them safely and minimise the identified risks.
People's medicines were being managed safely and administered by trained staff. Medicine administration records contained updated guidance to staff and were fully completed. Changes in people's health were identified quickly and staff supported people and their relatives to contact their health care professionals.
People spoke highly of the staff that provided their care and people’s relatives were also complimentary of staff. Staff we spoke with demonstrated they were aware of people’s individual needs and understood their preferences.
Staffing levels were sufficient to meet people’s needs and protected them from harm. The service carried out pre-employment checks on staff before they worked with people to assess their suitability.
Staff received regular supervision to discuss their progress and training needs. Spot checks were completed by senior staff to monitor staff performance and ensure people were receiving support in line with their needs and expectations.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood the importance of gaining consent from people and acted in accordance with the principles of the Mental Capacity Act 2005. The registered manager knew when assessments of people's capacity to make decisions were needed. Staff assumed people had capacity and respected the decisions they made.
People told us staff were kind and caring and treated them with dignity and respect at all times. Staff were kind, caring and supported people if they became anxious. People who wished to were supported to develop their independence. Staff supported people to take part in leisure activities they liked.
People who used the service were provided with personalised care, which was based on their individual needs, wishes and goals. People were fully involved in the development of their care plans and felt their views and opinions about how their care was provided were encouraged. Care records were reviewed with people and they had been provided with sufficient information about the service. The service had had an effective system in place to manage complaints.
People received a service that was well led because the registered manager provided good leadership and management. Systems were in place to check on the standards within the service.
The registered manager had an effective system to regularly assess and monitor the quality of the service that people received. Quality assurance systems involved people who used the service.