Archived: Prestige First Call

The service is registered to provide personal care to people living in their own homes. The service can provide care and support to older people and younger adults, people with mental health conditions, people with a physical disability, people living with dementia, people with a sensory impairment or those people who need end of life care.

The service had a registered manager who was also the registered provider. 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.

Systems in place for the management and administration of medicines were not adequately robust, which meant there was a risk of people not receiving their medicines safely.

Recruitment and selection procedures were in place, but we saw not all appropriate checks had been undertaken before staff began work. For example, they did not always have references in place.

Prior to the commencement of the service staff completed environmental risk assessments of the person’s home and ensured equipment was in safe working order.

There were risk assessments in place for people who used the service, covering areas such as mobility. However not all known risks had been assessed and recorded in areas such as pressure care and swallowing difficulties.

Assessments were undertaken to identify people’s care and support needs. Care records we saw contained information about the person's likes, dislikes and personal choices. However changes in the support people needed was not always reflected in the care plan.

The registered manager and staff we spoke with had been trained and had an understanding of the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. All staff could describe how they had used their knowledge to support people to make their own decisions and work in people’s best interests. However they had not recorded their assessments or best interest decisions in peoples care records.

There were enough staff employed to provide support and ensure people’s needs were met.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice.

Staff told us the registered manager was supportive, and staff had received regular and recent supervision and an annual appraisal. Staff training was up to date and well managed. Staff told us they had received training which had provided them with the knowledge and skills to provide care and support.

People and family members told us staff treated people with dignity and respect.

People were supported appropriately where needed with their food and drink, which helped to ensure their nutritional needs were met. Staff worked and communicated with social workers, occupational therapists, hospital staff as part of the assessment and on-going reviews for people.

The registered provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident staff would respond and take action to support them.

There were systems in place to monitor and improve the quality of the service provided but they were not always recorded, and the range of audits was not robust. The registered manager told us this was an area they were committed to develop in the future. Staff told us the service had an open, inclusive and positive culture.