Prestige Care & Support Ltd

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

People were not always protected from the risk of abuse and harm. Robust risk assessments and safeguarding processes were not in place to ensure people received safe care. Robust systems were not in place to minimise the risks of infection when supporting people. Staff were not trained in key area such as catheter care to ensure people received safe care. Lessons were not always being learnt following incidents to improve the service. There were enough staff to support people safely in a timely manner. Medicines were being managed safely. Systems were in place to recruit staff safely.

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We received concerns from a relative about incident that occurred and they had not heard about any learning that had taken place. We also found shortfalls that meant learning has not taken place to minimise the risk when supporting people with meals.

The registered manager told us that lessons were learnt where possible from incidents and this was shared with staff. However, a staff member told us that they do not always hear about learning to ensure they can provide safe care and support to people. Systems would need to be made more robust to ensure all learnings were captured following incidents and shared with all staff to minimise risks to people and keep people safe at all times.

Robust systems was not in place to learn from lessons following incidents. We saw evidence that lessons have not been learnt in full following incident on eating and drinking as we found shortfalls in people’s risk assessment to ensure risks associated with eating and drinking was minimised.

People and relatives had no concerns in this area.

The registered manager told us that the service collaborates closely with people and their families to ensure that people’s care and support is delivered in a way that is safe and supported to them. This is captured at the needs assessment stage and shared with people and their families on how they will deliver their support. Staff told us how they supported people to move in between services safely such as with healthcare appointments when required.

We saw assessments had been carried out to determine if people could be supported safely. Systems were in place to support people with healthcare appointments when required and work in partnership with healthcare professionals. However, the manager stated that they don’t ask for any information regarding choking risk unless this was highlighted on the referral form or if the person or relative has informed them. The manager agreed to review their assessment form to capture this information.

We received mixed feedback from people and relatives about people being safeguarded from risks. A relative told us, “All the carers are all really pleasant, they do everything I want and need them for me.” However, another relative commented, “Prestige is a bit hit and miss, some of the care staff are very good but others I feel don’t really care about the person they are looking after.” Another relative told us that an incident occurred as staff did not follow safe processes to ensure the person was safe. Safeguarding systems would need to be made more robust to ensure people’s experience was safe at all times.

Staff had been trained in safeguarding and the staff we spoke to were aware on how to safeguard people from harm and who to report concerns too. However, we also received concerns from staff members that when supporting people for the first time, staff were sent to support people without training and care plans in place. This meant that people may be placed at risk of harm. The registered manager told us that during the staff induction programme, staff are given the safeguarding policy to read. However, although staff were aware of safeguarding processes, we found that they had not received certified training in key area such as cathetar care to ensure they provided safe care and support when supporting people.

Robust processes were not in place to safeguard people from abuse and harm. Learning had not taken place following incident to ensure people were safe when being supported with meals and we had to raise a safeguarding as we found a person had not been supported with catheter care safely.

Systems would need to be made more robust to ensure risks were minimised and people received safe care at all times. A relative told us, “At the start we had a problem with [person’s] food preparation as some of his carers did not really know how to prepare what he was having. I rang the office, and the manager visited us and the care staff received some extra training. We have not had any problems since.” Another relative commented, “I have raised some concerns about not having some of the carers as they don’t really do what they are supposed to.”

Some staff members stated that there have been some issues when supporting people for the first time as their care plan had not been sent to staff. A staff member told us, “Sometimes you go in and there isn’t a folder. Sometimes you go in blind. For example, a new client, you ask about new information in the office and they don’t have it.” Failure to provide staff with sufficient information to support people safely, placed people at risk of harm.

Robust risk assessments were not in place to ensure people received safe care. We found when supporting people with meals, assessments had not been carried out to check if people were at risk of choking, how the food should be prepared, and the position people should be supported with when eating and drinking to ensure they were safe at all times. We also found the assessment did not include if people can eat independently or require staff support. This meant there was a risk people may not receive safe care and support at all times. Risk assessments had been completed for people at risk of falls and skin complications.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We received mixed feedback about staff support when speaking to relatives. A relative said, "I have no complaints at all with Prestige." Another relative commented, “The carers are very mindful of his needs and how his condition may change, and they look after him well." However, we also recieved concerns from relative about staff support. A relative told us, “I feel that the service has poor standards when they employ staff, and I don’t feel that they get enough training before they come to look after people.” Another relative also told us that staff do not complete personal care in full, leaving the person without proper care and support."

We received mixed feedback from staff on training. A staff member commented, “Yes, training is good.” However, another staff member told us, “The training is not suitable for some of these clients. Everything is done online, should be in-house training. Only in-house training is manual handling. 1 (staff member) did not how to put a slide sheet on and has not been appropriately trained to identify choking risks.” Robust systems would need to be in place to ensure staff were trained in key areas to perform their roles effectively.

We found staff had been trained in a number of key areas such as with safeguarding, medicines and basic life support. However, we found that staff supported people with catheter care and training had not been provided in this area from a qualified professional. We received concern from a relative that a person had not received safe support when being supported with catheter care. We fed this back to the registered manager, who informed training from a qualified professional will be delivered on catheter care. There were appropriate numbers of staff to support people safely and provide care and support in a timely manner. A relative told us, “The carers come when they are supposed to, and they always stay their allotted time, my father is never rushed, and they always make sure, he has everything he needs before they do go.” Systems were in place to recruit staff safely. Pre-employment checks had been carried out such as criminal and identity checks and references had been sought. Staff had received regular supervision to ensure they were supported in their roles.

We received concerns about a person not being supported safely when being supported with catheter care. This placed the person at risk of infections. A relative also told us, “Tidying up after themselves is a real issue and the kitchen can be left dirty, pots in the sink and the worktops not wiped. No matter how much I ask them to clear up after themselves it seems to land on deaf ears. I wish the manager would do spot checks so she could see for herself.” We fed this back to the registered manager who told us this has been addressed. Robust systems would need to be put in place to ensure people’s experience was safe with infection control.

The registered manager told us that a infection control policy was in place and staff were trained in infection control. However, infection control systems would need to be made more robust to ensure staff supported people safely to minimise risks of infection relating to cathetar care support.

The service supported people with catheter care, and we found risk assessments had not been completed in this area to minimise the risk of infections when staff supported people with catheter care. An infection control policy was in place and staff had been trained on infection control. Personal Protective Equipment (PPE) was readily available, and staff confirmed they had access to PPE when needed.

People received their medicines safely. A person told us, “Yes, the carers do my tablets (medicines) and I have never had any problems getting them when I should.”

Staff told us how they administered medicines safely and confirmed they had received training in this area.

The provider had a medicines policy. Staff completed medicines training before they were able to complete medicines tasks. Staff signed the paper medicines administration record (MAR) charts to show that medicines were given as prescribed. There were protocols available to guide staff on how to manage ‘when required’ medicines.