Archived: Premier Care Limited - Cheshire Branch

Updated 8 May 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We gave the provider 48 hours’ notice of our inspection to provide an opportunity for people being supported to speak to the inspection team. Due to the size of this service, this inspection took place over five different days covering between 3 and 23 December 2014.

The inspection team consisted of three adult social care inspectors who visited the service on 18 December 2014. We also had two experts by experience who assisted with the inspection by carrying out telephone interviews to people who received support. An expert by experience is a person who has personal experience of this type of care service. We also had a specialist advisor in the Mental Capacity Act who visited people in their own homes having gained their permission and consent to carry this out.

During this inspection, we spoke with a variety of people via telephone including: 17 people using the service and nine next of kin. In addition, having gained consent and permission, we also visited four people and their families in their own home. We spoke with 17 staff, we also met one of the directors for the service and the registered manager.

We used a number of different methods to help us understand the experiences of people using Premier Care Ltd. We looked at a sample of documentation in relation to how the service was operating, including records such as; staff recruitment and 16 staff files showing supervision and training; complaints; risk assessments; surveys; minutes of meetings; quality assurance audits and policies and procedures. We looked at a total of 16 support plans for people provided with support.

Before our inspection we request that services provide us with a provider information return [PIR] which helps us to prepare for the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. However the staff informed us they had not received this request which meant we did not have this PIR prior to our inspection. We looked at notifications received and reviewed all other information we held prior to visiting. We contacted Warrington and Halton local authority which had responsibility both for safeguarding and commissioning services from Premier Care Limited. We reviewed all the information held by the Care Quality Commission (CQC) relating to this provider.

Updated 8 May 2015

This inspection took place on the 3/4/18/22/23 December 2014 and was announced with 48 hours’ notice given to allow for arrangements to be made to speak with people who received support from the service.

The service had a 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 and associated Regulations about how the service is run.

Premier Care Limited - Cheshire Branch is owned by Premier Care Limited. It is registered to provide personal care to people living in their own homes. The service provides staff to support approximately 350 people of all ages with a range of support needs. It is a large domiciliary care service and people are provided with a range of hours of support per day or per week in line with their assessed needs across the Halton, Cheshire and Warrington area.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) to report on what we find.

Staff had not received training in the Mental Capacity Act 2005 and they were limited in their understanding about the Mental Capacity Act (MCA). We found the service needed further development in training their staff and in their understanding of how to support people when they lacked capacity. The MCA guidance helps identify and protect the interests of people who lack the ability to consent on various issues.

This was in breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Recorded care reviews showed that people supported by this large service were included with regard to how their care was managed. However, the sample of people we spoke with felt improvements could be made to the management of the service regarding main themes involving, the management of staff teams, lateness and communications. Most people told us that ideally they wanted an up to date staff rota to inform them of who they could expect to be providing their support each week and ideally they wanted the stability of a team of carers who they knew to provide their support.  We have made a recommendation for the service to regularly monitor and assess the quality of the service and have regard for people's comments and views expressed about the service.

The service had a quality assurance system in place which had recently been revised to offer improvements in the management of the service. They had various checks and audit tools to show how the provider and registered manager were checking on the standard of services offered and with regard to what changes they had made to help improve the service.

The majority of people being supported by this service and their relatives were happy with the standard of support provided by their support workers. They told us that staff were caring and respectful to them. They were positive about the staff and gave lots of compliments about their caring attitudes.

Staff recruitment was very organised with detailed checks to help show good practices in employing those people assessed as suitable to provide support to people within this service.

Staff had a good understanding of their duty of care to ensure people were safe. They understood their safeguarding procedures and the service had accessible procedures and training to ensure people were always safeguarded.