Background to this inspection
Updated
2 April 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Service and service type:
The service is registered to provide personal and or nursing care to people in their own homes.
The service specialises in supporting people with complex health and medical conditions to stay in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
We gave the service five days’ notice of the inspection site visit because we needed to make sure that people could speak to us. We also visited the office location on 19 February 2019 to see the manager and office staff, and to review care records and policies and procedures.
The inspection was carried out by two inspectors and an Expert by Experience( Ex by Ex) . An Ex by Ex is someone who has personal experience of using services. Our Ex by Ex had experience of Homecare Services.
What we did:
Before our site visit we looked at information we held about the service. This included previous inspection reports and notifications sent in by the provider. Notifications are incidents the provider is required by law to submit to CQC.
We asked for a Provider Information Return (PIR) before our visit. This is a form asking the provider to give some key information about the service, what the service does well and improvements they plan to make.
The inspection:
We interviewed by telephone 10 people who used the service and four relatives. During the inspection we spoke with the registered manager, a care manager, a nurse manager, and a coordinator. We also spoke to two supervisors and five care workers.
We also received feedback from a health care professional.
We looked at four people's care records, four staff files and a range of records relating to the management of the service.
Updated
2 April 2019
About the service: Prestige Nursing Agency is a service that provides personal and nursing care to people in their own homes. It is not registered to provide accommodation to people.
The agency specialises in supporting people with complex physical conditions and disabilities
People’s experience of using this service:
• The service had a very experienced registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
• There was also a care manager who took management responsibility for matters related to the care needs of people who used the service.
• The team and people we spoke with were very positive about the managers. People benefitted from an outstandingly caring service. People and families all told us how they were treated with exceptional kindness, compassion and total respect.
• The service was caring and supportive to people. People were very well supported to live meaningful and fulfilled lives. Families and people felt full confidence that people’s changing needs would be met.
• Staff were described as compassionate and they demonstrated empathy, understanding and warmth. Staff had an enhanced knowledge of the people they cared for. Feedback from people and their relatives was extremely positive.
• We received really positive feedback on how staff were supportive, as well as how staff went the extra mile to get care just right for people. One person told us, “Yes they are brilliant; they accommodate me in every way.” Another person said, “They are very lovely with my daughter.” A further comment was, “They are part of our family now.”
• The values of the service were embedded in the service and its staff. People and staff felt respected, listened to, and empowered. There were many ways that the service went that extra mile to exceed people's expectations and hopes for the service. For example, they held regular social days and invited everyone who used the service and their relatives and friends to come. Feedback showed this significantly improved people's physical and emotional wellbeing and reduced their risk of isolation.
• People received personalised care and support specific to their needs and preferences. People and families decided who provided their care and support and when. Each person was fully respected as an individual, with their own social and cultural diversity, values and beliefs. People had their human rights upheld. People had care plans in several different formats to suit their needs.
• The whole service has continued to have a good track record at providing a very good service. The service ensured people remained at the heart of the local community with community links. There were different community groups that people regularly went to.
• Staff were motivated and proud of the organisation. Staff said the service was very friendly and supportive. The staff felt the culture was positive from the top to the bottom. There were high levels of satisfaction across all staff.
• People continued to receive safe care and support from staff who understood their responsibilities to manage risks and report concerns. This was where there were any issues relating to people's safety.
• Medicines were managed safely. Care calls were closely monitored. This was to make sure people did not experience missed visits. People, their relatives and healthcare professionals told us they were happy with the care and support.
• The manager led the team by example, showing strong, positive inclusive and creative leadership. The manager and team focused constantly on driving up quality in the service and creating very positive outcomes for people.
• The service had a culture that respected and valued people and staff. Ways to continually improve the quality of care were always being looked at. This was to ensure high quality outcomes for people.
• Staff said communication was very good from senior staff and they felt valued. Staff were positive about the support and training opportunities. Staff were supported to gain skills and knowledge to understand how to meet people's needs.
• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
• Staff were supported to gain skills and knowledge to understand how to meet people's needs. Staff had a caring approach to their work and the service had a strong, visible person-centered culture. This meant people were at the centre of how the service was run.
Rating at last inspection:
The service was rated Good at the last inspection
Why we inspected: This was a scheduled inspection planned based on the previous rating.