Archived: Prestige Nursing Peterborough

Updated 8 December 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 was planned to check 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.

This inspection took place on 30 October and 02 November 2015, and was announced. We gave the service 48 hours’ notice because we needed to be sure that the manager and staff would be available. The inspection was completed by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we looked at information we held about the service and used this information as part of our inspection planning. We asked for feedback on the service from a representative of the Peterborough City Council contracts’ monitoring team and a hospice clinical lead nurse to help with our inspection planning.

We spoke with six people and one relative of a person who used the service by telephone. We also spoke with the branch manager, a care co-ordinator, a branch assistant/ care worker, and two care workers.

We looked at four people’s care records, the systems for monitoring staff training and three staff recruitment files. We looked at other documentation such as quality monitoring records, accidents and incidents records and a business contingency plan. We saw records of weekly contracted/commissioned work hours, compliments and complaints records and four medication administration records.

Updated 8 December 2015

Prestige Nursing Peterborough is a domiciliary care agency registered to provide personal care for people living in their own homes. They are also registered to provide staff for care homes, hospitals and hospices. They are also registered as a nurse agency. There were no nurses being supplied by the service on the day of our inspection. There were 19 people being supported with the regulated activity of personal care in their own homes at the time of our inspection.

We carried out an announced comprehensive inspection of this service on 08 July 2014. A breach of one legal requirement was found. This was because people who used the service were not protected against the risks of receiving care that was inappropriate or unsafe. After the comprehensive inspection the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

This comprehensive inspection was carried out on 30 October and 02 November 2015 to check that the provider had followed their plan and to confirm that they now met legal requirements. We found that the provider had followed their plan, which they told us would be completed by 23 July 2015 and legal requirements had been met. We gave the service 48 hours’ notice of our inspection.

There was no registered manager in place during this inspection. There was a branch manager in place whilst arrangements were being made to fill the registered manager post. 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. The manager told us that no one being supported by the service lacked the mental capacity to make day-to-day decisions. There had been no requirements to make applications to the authorising agencies. Staff demonstrated to us that they respected people’s choices about how they wished to be supported. However, not all staff were able to demonstrate a sufficiently robust understanding of MCA and DoLS to ensure that people did not have their freedom restricted. The lack of understanding increased the risk that staff would not identify and report back to the management that people were having their freedom restricted in an unlawful manner.

Individual risks to people were identified by staff. Plans were put in place to reduce these risks to enable people to live as independent and safe a life as possible. Arrangements were in place to ensure that people were supported with the safe management of their prescribed medication.

People, where needed, were assisted to access a range of external health care professionals and were assisted to maintain their health. Staff supported people to maintain their links with the local community to promote social inclusion. People’s health and nutritional needs were met.

People who used the service were supported by staff in a caring and respectful way. Individualised care and support plans were in place which recorded people’s care and support needs. These plans prompted staff on any assistance a person may have required.

People and their relatives were able to raise any suggestions or concerns that they had with the manager and staff and they felt listened to.

There were pre-employment safety checks in place to ensure that all new staff were deemed suitable to work with the people they were supporting. There were enough staff available to work the service’s number of commissioned and contracted work hours. Staff understood their responsibility to report any poor care practice.

Staff were trained to provide care which met people’s individual care and support needs. Staff were assisted by the manager to maintain and develop their skills through training. The standard of staff members’ work performance was reviewed by the management through observations and supervisions. This was to make sure that staff were confident and competent to deliver this care.

The manager sought feedback about the quality of the service provided from people who used the service. Staff meetings took place and staff were encouraged to raise any suggestions or concerns that they may have had. These meetings and the organisation’s website and newsletter were also used to update staff about the service. There was an on-going quality monitoring process in place to identify areas of improvement required within the service. Where improvements had been identified the manager had actions in place to make the necessary amendments. However, not all actions taken were formally recorded.