About the service Premier Care Halton is a domiciliary care agency providing care to people living in their own homes, so they can live as independently as possible. At the time of our inspection the service was supporting 345 people with personal care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
The service is contracted to provide personal care by Halton Borough Council. Premier Care – Halton Branch then sub-contracts approximately 140 people's care packages to another service in the area. For the purposes of this inspection, care packages that were being fulfilled by the sub-contracting company were not looked at.
People’s experience of using this service and what we found
Medicines were not always well managed. There were concerns with the recording of administration and audits had not always been effective at identifying concerns. Risks to people’s health and well being were not always assessed appropriately. Risk assessments relating to bed rails and specific health conditions were either missing or not completed sufficiently. The provider had addressed some of the concerns before the end of the inspection.
People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Mental capacity assessments had not always been completed when appropriate and best interest meetings had not always been recorded. People were supported by a well trained staff team who felt supported by management.
There were systems in place to monitor the quality and safety of the service through auditing, however these were not always effective at identifying concerns found at this inspection. There were not always clear actions in place to address concerns that had been identified. The provider and manager were responsive to concerns raised during the inspection.
People told us they had good relationships with the staff that supported them. People were treated with dignity and respect. Staff supported people to express their views about the service and their care. People were supported by a consistent staff team who knew them well.
People and relatives told us the service was person-centred. There was a complaints procedure and any received were investigated and responded to. Staff and people told us that when they had raised concerns with the management team they had been responded to appropriately. People’s communication needs were recorded, and staff supported people day to day in ways that met their needs. However, information about the service had not always been made available to people in a way that was suitable for their communication needs. We made a recommendation about this.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 13 February 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made, however we found other areas of concern and the provider remains in breach of regulations
Why we inspected
This was a planned inspection based on the previous rating
Enforcement
At this inspection we have identified breaches in relation to the safe management of medicines, risk assessments, consent and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will arrange to meet with the provider to seek assurances about concerns raised at this inspection. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.