Premier Carewaiting Limited

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• 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

Robust systems were not in place to ensure staff attended calls on time. Some staff were not given time to travel to care calls, which meant they were late to calls. We made a recommendation in this area. People were protected from the risk of abuse and harm. Risk assessments were in place to ensure people received safe care. Systems were in place to ensure staff were recruited safely and were suitable to support vulnerable people.

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.

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

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff told us they were trained on safeguarding and were aware of how to keep people safe, what abuse is and who to report abuse to. A staff member told us, "I have received training on safeguarding. If I see abuse, then of course I will let my manager know straight away.” Staff were aware on escalating concerns to external agencies such as the local authority or Care Quality Commission if needed. Another staff member commented, "If I see someone being abused, then I will let my manager know. If they do not do anything, I know I can go to the safeguarding team or CQC.” The registered manager was aware of their responsibility on how to protect people from abuse. Staff told us they always asked for consent before supporting people with care. A staff member told us, "We ask for consent because they need to be ok with us helping them. We always ask them." The registered manager told us that MCA assessments had been completed to assess if people had capacity to make certain decisions. If people did not have capacity then the best interest decision process was followed.

There were processes in place to minimise the risk of abuse. A safeguarding policy was in place that detailed the types of abuse and how to escalate concerns if staff suspected or see abuse to ensure people were protected. A whistleblowing policy was in place, and this gave guidance to staff on how they could raise concerns about any unsafe practice. Staff had been trained in safeguarding adults and understood how to protect people from harm and who to report to when required. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. Systems were in place to obtain consent from people to provide care and support. Consent forms had been completed to ensure people consented to receive care and support from the service. Staff had been trained on the MCA. The registered manager and staff were aware of the principles of the MCA. Staff told us that they would always request people’s consent before doing any tasks. People were able to make day to day decisions about their lives. For example, they were able to chose how they wanted to be supported. Where people did not have capacity to consent to care and treatment, then MCA assessments had been carried out and best interest decision process was followed.

People were protected from abuse and felt safe. People and relatives told us they received safe care from staff. A person told us, "I do feel safe with the staff supporting me because I have now got used to them and feel confident with them, after 3 years of them visiting me." Another person commented, "Yes, I have no problem with the carers and feel very safe with them. They get on with their job and are all very nice and friendly." A relative told us, "Yes, mum does feel very safe with the carers because she knows who her carers are."

Staff knew people well and knew about their health needs and risks. They told us they found the risk assessments helpful, which gave them guidance on how to keep people safe when they supported them. A staff member told us, "I always find their care plans and risk assessments helpful." The registered manager told us the importance in ensuring risks were identified and assessments were robust to ensure people received safe care at all times. The registered manager told us peoples care were reviewed regularly to ensure any new risks can be identified so people received safe care and support.

Risk assessments were in place to ensure people received safe care. They contained information about specific risks to people for staff to be aware of. These included risks related to people’s health conditions, such as diabetes or epilepsy and actions to take to minimise the risk. Risk assessments had also been completed for people at risk of falls and skin complications, which included measures to minimise the risk. The provider also had environmental risk assessment in place to ensure peoples home were safe when staff supported people.

People and relatives told us that staff looked after people well, which included minimising risks to ensure people were safe. A person told us, "All the carers are brilliant and do a fantastic job looking after me and don't mind what I ask them to do as they are always willing to help me." A relative commented, "They are fine and do a good job supporting my wife."

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

Staff told us they were given their rotas in advance and were able to get to care calls on time. A staff member told us, "I have had no missed calls. My rotas are given to me a week before so I know where to go. I am given time to travel to visits. “ They also told us they were supported well by the management team and had been trained to perform their roles effectively. A staff member told us, "[Registered manager] is very supportive and provides good advice. She is a good manager and is approachable." Another staff commented, "I have been trained really well.”

Robust systems were not in place to ensure staff attended calls on time. We checked staff rota and found some staff were not given time to travel in between care calls to ensure they were not late to care calls. We also found some entries on rotas that showed two people required support at the same time. We also analysed call logs and found a number of entries that showed staff were late by more than 15 minutes. We fed this back to the registered manager who informed they recently implemented a digital system, which resulted in rotas being incorrectly scheduled and this is being addressed. The registered manager confirmed after our feedback that rota has been changed to reflect time to travel for care calls and separate times for people to receive care. We recommend the service follows best practice guidance on ensuring staff are able to attend care calls on time. Staff had completed mandatory training and refresher courses such as moving and handling, safeguarding and basic life support to undertake their roles effectively. The registered manager had a training matrix, which provided oversight on staff completion of training and when training was next due. New staff members had received a induction, which involved shadowing experienced staff. Supervisions had been carried out regularly to ensure staff were supported. Pre-employment checks had been carried out to ensure staff were suitable to work with vulnerable people. Checks included obtaining proof of staff identity and the right to work in the UK. References had been requested and completed to ensure staff were of good character. Disclosure and Baring Service (DBS) checks had been made to ensure staff were suitable to work with vulnerable adults and children. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

People and relative were positive about the staff who supported them. A person told us, "Yes, absolutely my carer is very knowledgeable and reinforces good support." A relative commented, "I think they are well skilled and knowledgeable and so does my wife." However, some people raised concerns with staff time keeping, a person told us, "The carers can be sometimes early or sometimes late." We fed this back to the registered manager who informed they will address this with people.

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

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