Premier Community

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 consistently told us they felt safe with the care they received and the staff who entered their home. People were supported by appropriately trained staff who had been recruited safely. People and relatives said they were regularly asked for their views and opinions on the care they received and felt their comments were valued by the service. Medicines were administered and recorded safely, and people were confident in staff’s ability to support them to manage their medicines.

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.

People we spoke with told us there had been improvements since the last inspection. One person said, “They [management] do listen and act really quickly, it shows they want to get things right and make sure mistakes don’t happen again.”

Staff told us the management team were open with them and freely communicated concerns and lesson learned. One staff member said, “This has been invaluable, we learn and improve from each other. We share best practice this way but more importantly we share best practice for the individual. Everyone has their own preferences, and they no longer have to repeat it to every staff member who goes into their home because we communicate and learn.” The registered manager and managing director had successfully shifted the culture from a blame culture to one that was open and transparent and about learning rather than blame. This was reflected in staff survey feedback and in the reduction of reoccurring accidents and incidents.

The service had a proactive and positive culture of safety based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Quality monitoring systems such as audits were used effectively to highlight areas of improvement and identify trends. For example, audits were reviewed daily to ensure call times and the length of time staff stayed with people were consistent. This had reduced complaints and improved people’s daily care experience.

Everyone we spoke with told us they had been supported appropriately and safely to start a service with Premier Community. People told us they had a meeting to discuss their needs prior to the service starting. They were introduced to staff so they knew who would be attending the property and received regular contact from the office staff to ensure they were happy and satisfied with their care package.

Staff supported the feedback received from people. They told us they were allowed time to review care plans to ensure they understood people’s needs before care commenced and were introduced to people to allow them to start building an open and trusting relationship.

We spoke with staff at the local authority who had supported people to transition into the service with Premier Community. One professional said, “The registered manager and staff go above and beyond to make sure the care package meets people needs. They have come up with innovative ways to support people and keep them living at home. It’s mainly down to person centred care and them having the willingness to listen to people and their families. I cannot fault them.”

We saw evidence of pre-assessment plans and checks being completed by trained and competent staff members to ensure the provider could meet people's needs. Where additional needs were identified, such as mobility equipment like a rotunda or wheelchairs, appropriate referrals were made. People received weekly calls and face to face meeting after 6 weeks to check care met people needs. The registered manager was proactive in ensuring people received safe and appropriate care from day one of staff attending people’s homes.

People told us they were kept safe from the risk of harm, abuse and neglect. One person said, “Staff are very good, if I have a problem, they know how to deal with it and they keep me safe.” A relative told us how staff had supported them to report concerns about their loved one to the local authority to make sure they stayed safe. One person said, “My [relative] started to neglect themselves, they [staff] supported me to report the concerns and make sure [name] was safe and looked after.”

Staff told us they received training in safeguarding and annual updates to this training to ensure their knowledge remained current. Staff said they were offered opportunity to discuss their concern and gain advice and support from colleagues. One staff member said, “We discuss safeguarding at team meetings. It helps keep people safe, but it also helps us if we talk about situations and let managers know if we have concerns before they develop.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The registered manager kept clear records and logs of all safeguarding concerns. We saw evidence that concerns were raised in a timely way with the local authority and CQC as per legal requirements.

People told us they were involved in assessments of risk associated with their care and support. For example, people had assessments associated with the risk of trips or falls, mobility, diet and nutrition. When there were risks, people were supported to access additional services, for example, physiotherapy and occupational therapy assessments.

Staff were knowledgeable about people’s health conditions and risks but explained the importance or supporting and encouraging people to take positive risks. One staff member said, “Most people’s primary goal is to remain living at home, and I support this by helping them to remain independent. I don’t do jobs or tasks for people, I ask them what I can do to help them do the tasks themselves, whether that’s getting dressed or washing the pots.”

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. We saw evidence of people being supported to improve their mobility and independence whilst reducing and monitoring their falls risk.

People told us when they first started to receive a service from Premier Community, a member of staff completed an environment assessment to ensure it was safe for the delivery of care. One person told us, “They (staff) checked to make sure things like my smoke detectors worked and where the gas mains and water was in case of emergency, that good because I can’t reach those things.”

Staff told us that they prioritised keeping people safe and making sure their home environment was a safe as possible for them. One staff member said, “We work in people’s homes and have to respect how people want to live, but most people like knowing we understand how to support them in an emergency or that we want to support them to keep the rooms tidy so they don’t fall. It’s about no overstepping.”

Care plans and risk assessments contained clear information about people’s environment and potential risk to people and staff. Where risks had been identified staff were provided with clear guidance on how to reduce this risk and a process to support people in an emergency. For example, where pathways around people homes were dimly lit, staff had been provided with equipment to improve their safety.

Everyone we spoke with told us they were support by a consistent team of staff members. Where new staff were introduced, people confirmed they shadowed existing staff to enable them to get to know people and understand their care needs. One person said, “The staff are great, you get to know them and get to have a chat about life and not just care. It means so much more.”

Staff were very positive about the ongoing training and support they received. Staff gave example of a positive culture that had been developed since our last inspection. One person said, “The office has an open-door policy, we can get help and support anytime. I have a named office staff member who I can talk to. This has improved confidentiality, meaning I have more confidence to speak up and ask for help where needed.” Another staff member said, “I have worked in care for over 20 years, and this is by far the best company I have ever worked for. They listen, I am not over worked, they have reward incentives and there is real career progression if you want it.”

We saw evidence that the provider and registered manager had learned lessons from the previous inspection and now ensure people received timely and consistent care. Quality monitoring process had been implemented that ensured potential missed visits were flagged early and this had significantly reduced late and missed calls. This was also supported by a consistent team of bank staff who could support in the event of staff absence. We saw new processes had been implemented where staff gave constructive feedback to new starters supporting them to learn and integrate into the service quickly. The provider and registered manager regular sought people’s feedback about staffing through care plan reviews and surveys and these resulted consistently showed people felt support and were happy with their care staff and call times.

People told us that staff were respectful in their home, helping them to maintain cleanliness where needed and staff wore Personal Protective Equipment (PPE) appropriately. One relative said, “I can’t fault staff, they go above and beyond like putting the laundry on if needed following accidents. They always have PPE with them, and they always wear it if their doing personal care with [name] and they dispose of it properly too.”

Staff confirmed that they have access to a consistent supply of PPE equipment and were trained in the correct procedures for its use and disposal. Staff were knowledgeable about risks such as cross infection and contamination and knew how to keep people safe from these risks.

Care plans we reviewed contained clear guidance for staff on how to support people in a person-centred way whilst protecting them from infection prevention and control risks. Best practice guidance was also documented for staff such as methods and timeframe for handwashing. Management completed consistent competency steps with staff which included observations and feedback of their PPE and Infection Prevention Control (IPC) practices which promoted safety and improvements.

Not everyone we spoke with was supported with medicines. Where people were, they told us staff were knowledgeable about medicines and ensure they received their medicine safely and timely. One person said, “Staff are very good, they help me everyday and know how I like to take my tablets.”

Staff were knowledgeable about medicines safety and administration. Staff we spoke with were able to explain how they would act and respond to a medicines error and how they would keep people safe. Staff told us they were confident to raise errors or concerns with management. One staff member said, “Errors can happen, medicines can get really complex, but I know management will support me and help me sort things out. This makes sure people are safe and gives me confidence to administer medicines.”

The provider and management team had made improvements since our last inspection and acted on the feedback we gave. The provider had updated their electronic care planning and recording system to support staff to clearly document and identify where medicines had been administered or prompted only. Where time specific medicine were required, there was a daily audit which monitored these time frames to ensure they were met and there were detailed contingency plans in place for emergency situations to ensure people still received their medicines as required. This included situations such as absence of staff or adverse weather conditions.