Archived: Premier Care Blackpool Branch

Premier Care Blackpool Branch provides personal care and support to people living in their own homes within the Blackpool area. In addition to providing a domiciliary care service, the registered provider also manages one supported living home for people with mental health needs.

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. At the time of our inspection there were 85 people using the service.

People’s experience of using this service and what we found

The lack of suitable staff meant support could not consistently be provided for some social activities. We have made a recommendation about this. Some historic incidents had not been reviewed as part of Premier Care Blackpool’s governance system. We have made a recommendation about this.

People were protected from the risk of harm and abuse. Clear policies and procedures were in place, staff had received training and felt confident to raise any concerns they had. Staff were recruited safely. The manager took a systematic approach to ensuring there were enough staff deployed in specific geographical areas to meet people’s needs. We were assured that the provider was using PPE effectively and safely.

Management and staff displayed a clear vision and consistent values in the provision of care and support which was as individual as the person receiving it. The provider worked in partnership with health professionals in managing risk and supporting people with their underlying health conditions. People and staff spoke positively about the management team, who worked alongside staff and had oversight of the service delivered.

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.

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 and the provider was no longer in breach of regulations.

At our last inspection we recommended that the registered provider continued to embed suitable auditing systems to consistently promote safe and high-quality care. At this inspection we found the provider had made improvements to their auditing systems.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We carried out an announced comprehensive inspection of this service on 30 November 2020. A breach of legal requirements was found.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Premier Care Blackpool on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Premier Care Blackpool Branch provides personal care and support to people living in their own homes within the Blackpool area. In addition to providing a domiciliary care service, the registered provider also manages one supported living home for people with mental health needs.

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.

People’s experience of using this service and what we found

The service was not always safe. Medicines were not always managed safely. We found examples where people had been given their medication without full guidance being followed. Documentation around medicines was not always fully completed which meant people could have been exposed to risk. We discussed this with the registered manager and systems were in place to address the concerns. However, these changes required time to embed. We found recruitment of staff was safe. Staff had access to personal protective equipment, and they had received training on infection control. The service had procedures to minimise the potential risk of abuse or unsafe care.

The service was not always well led. At this inspection we identified some records relating to care and the management of the service were either incomplete, inaccurate and/or not kept up to date. We found no impact to people however, this could have compromised the quality and safety of the service provided. We have made a recommendation about embedding effective systems to monitor the service. There was a positive staff culture. We found the management team receptive to feedback and keen to improve the service. The registered manager worked with us in a positive manner and provided all the information we requested.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People's nutritional needs had been considered. People we spoke with said they were given choices on what meals and drinks they wanted.

The complaints folder showed complaints had been fully investigated by the registered manager and a full response provided to the complainant. Staff demonstrated a good understanding of the people they supported and were able to talk about people's preferred routines.

The registered manager and staff were caring. People told us they were happy with their care and staff treated them with kindness, dignity and respect. One person said, "I have never been shown anything but respect from the carers, the ones who come to me are very kind." Staff were aware of how to protect people's privacy and dignity.

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)

This service was registered with us on 4 April 2019 and this is the first inspection to award an overall rating. A focussed inspection was completed looking at Safe and Well-led (published 18 July 2020). As the inspection was targeted no rating was awarded, we found two breaches of the regulations relating to risk management, medicines and governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been sustained and the provider was still in breach of one regulation.

Why we inspected

This was a planned inspection based on the registration date and to follow up on previous concerns found at the focussed inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. We have identified a continued breach in relation to the management of medicines at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Premier Care Blackpool Branch provides personal care and support to people living in their own homes within the Blackpool area. In addition to providing a domiciliary care service, the registered provider also manages two supported living homes for people with learning disabilities and people with mental health needs.

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.

People’s experience of using this service and what we found

People told us they were supported by staff who knew them well. On the whole people within the domiciliary service told us they were happy with how their visits were planned and coordinated. Staff said they were not rushed. Although people told us they felt safe whilst being supported by Premier Care Blackpool Branch, the service was not safe. Medicines were not always managed safely and in line with good practice. Risk was not consistently identified, addressed and reduced. Staff did not always have the correct skills required to promote safety. The organisation had a safeguarding policy, but we could not be assured this had been fully implemented to keep people safe from the risk of abuse and harm.

On the whole, people told us they were happy with how the service was managed. However, we identified a number of failings regarding the oversight and governance of the service. Policies and procedures were not always consistently followed to maintain safety. For example, safeguarding, managing accident and incidents and staff training procedures were not consistently followed. Records were not always accurate, up to date and reflective of people’s needs. Not all documents we requested to see were made available to us. We reviewed eleven care records and identified concerns within ten of them. In addition, the registered provider failed to show they worked proactively with health professionals to ensure guidance was followed to keep people safe.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 04/04/2019 and this is the first inspection.

Why we inspected

We received concerns in relation to the management of medicines and management of risk. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We have identified breaches in relation to management of risk, management of medicines and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss what improvements they intend to make to ensure people are safe and the service is effectively governed. We will work with the 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.