Premium Homecare Ltd

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We assessed all the quality statements within this key question. Our rating for this question has improved to good. People and relatives now felt involved in their care and were happy with the care they received. However, we heard that some people felt communication from the management team could be improved, particularly around change of care workers. Improvements had been made to ensure more information about people’s individual preferences and what was important to them, was captured in their care records.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives generally said their family members received care that was personalised to their needs. One relative said, “Effectively [their family member] had 2 male care workers that have worked for him. There’s one particular male care worker that does some shopping and cleaning who he gets on well with. They have started to cook his meals as my [relative] isn’t able to cook his meals now”. Another family member told us the service responds well to changes in people’s care needs. They said, “They are ok at the moment, they are giving [my relative] time. Yes, they are taking proper time.”. However, another relative said that at times staff were too task focused. They told us, “I think they need to be a bit more caring about needs and understand what the needs are. They are a bit like a machine”.

Staff told us, I’m very happy with my job and everything I do for [people].” Staff provided people with personalised care and treated people with respect. They were aware of the level of support people required and worked with their colleagues in order to meet people’s needs. Staff said, “If I am working with a colleague, we would discuss with them whether we can both make the time. If I get to the home before my colleague then I wait in the person’s house for them to attend, and then we start the job. As we can’t put ourselves or the person at risk. And, “First we know about the care plan is the management informs us of everything. Then we visit the person and we speak with any relatives to get all the information.” Staff told us the new system enabled staff to support each other to improve communication and the sharing of information about people’s needs. Where staff could view each other’s notes, they were able to provide greater handover to ensure people received the level of support they required, and if some domestic duties could not be completed at a call, these could be easily picked up at the next call that day.

Most people and their relatives said they received support from consistent care workers who knew them well. One person told us, “[Care worker] is my main care worker and she is lovely. She treats me like her mum. She is really good and caring. I have had other care workers in the past but I never knew who they were. So, I asked to only have [care workers] which they are doing.”. A relative said, “[Their family member] has a group of 4 or 5 and depending on their shift pattern there is consistency and continuity. They are familiar with [their family member’s] routine which does help”. Family members said staff stayed the required length of time to meet their relatives needs most of the time.

Staff worked with other agencies in order to provide continuity of care. This included liaising with healthcare professionals working with people. A staff member said, “The physio will do training sessions with the care workers to talk us through how to support the person safely and support with their exercises. One person we support with massage to reduce her pain when standing up in line with guidance from the physio.”

We did not receive any feedback from partner agencies about continuity of care.

People’s care records included feedback from healthcare professionals. However, this guidance wasn’t always incorporated into people’s support plans. For example, we saw the occupational therapist had updated information about one person’s mobility needs and the equipment they required, but their risk assessments and support plans had not been updated to reflect this change.

Relatives gave us mixed feedback about if they were provided with up-to-date information about the support their family member receives. A family member said, “They are doing a really good service, honestly, if they are ever late, they always phone to say when they are behind. We are always kept in the link about when they are there or not there”. Another relative said “The care workers now know mum needs to know if they will be late as it agitates her, and this is getting better”. One person said the service is not always good at providing accurate information, “I don’t know who I have for the rest of the afternoon as I haven’t been informed. I only found out at lunch time that my care worker isn’t coming back for a few days so I don’t know who’s coming.” Another relative told us that communication with the service is not good, “They need to get better at communicating between the care worker and the office and then the office needs to tell me. I have to be proactive.” Another family member said, “They let us know in the week if they will be late but the weekend is different. If it is a regular, they will let me know, but if it is someone new, they don’t have my number so they don’t let me know.”

Staff told us they were aware of people’s communication needs and adjusted their style accordingly. The management team told us they had changed a person’s care worker due to their communication needs to ensure they were supported by someone who spoke the same first language as them.

Information was included in people’s records about any communication needs, including if they communicated verbally, and any visual or auditory impairment.

Some people told us the service reached out for feedback about their experiences of the care provided. A person said, “They sent me a questionnaire today in the post about my satisfaction, it came at lunch time”, and “Occasionally but not very often they will phone up and ask how I am”. A family member said “They do a good job and always pick up the phone. I wouldn’t change them”. Some relatives said there are processes in place to obtain their feedback about their experiences of care. However, others told us there is nothing in place to get their feedback about their experiences of care.

Staff told us they supported people to raise any concerns they had. They said if people raised concerns with them, they would listen to them and support them to raise those concerns with the management team. One staff member said, “Of course. If something is not right, I have to let them [the management team] know.”

A new system had been introduced to ensure complaints were recorded and acted upon. The electronic system contained a record of all complaints received and the action taken to address those complaints. Not many complaints had been received since our last inspection, but where they had, appropriate action had been taken to address the concern and apologise where downfalls were identified. There was also a system in place to record compliments received. Many of the compliments received related to a new system that was introduced to acknowledge people’s birthdays, so people felt valued and acknowledged on their special day.

Many family members told us their relatives were able to access care at a time and in a way that meets their individual needs. A relative told us “Yes, on the whole all the care workers that come from the agency are very good, they have built up rapport with my [relative]. They are flexible, they understand [the person’s] language which makes communication much easier”. Family members also told us care workers are respectful of their relative’s religion and culture. A relative told us, “Yes, they are very [understanding], they really are. Even though they are of a different faith and background they understand and accommodate to assist [the person] with their requirements of their faith”.

Staff were respectful of people’s individual differences and told us they tried to understand people more to ensure they were able to access the care they required. One staff member said, “I respect people’s religion and I try to understand my clients. I am working for them. I want to support them in the best way I can. If there is anything I don’t understand relating to a person’s religion then I will speak to my manager.”

We did not receive any feedback from partner agencies regarding equity in access.

Systems were in place to ensure people were not discriminated against and there was equity in access to the service and the level of care and support people required. This included matching people with care workers who spoke the same language as them.

People told us the care and support they received was tailored to their individual needs, which enabled equity in experiences and outcomes for people. A family member who does not live locally said the service listens to and involves them in decisions about their family member’s support. They said, “All these relationships have helped him and they have been very respectful. It makes a massive difference in terms of communication and really helps with his dementia. I can respond with [app] and the care worker will tell me little things that he thinks need addressing such as a bigger food shop order or anything he thinks needs addressing”. Many family members said they feel their relatives’ human rights were respected by the service, adding ‘they are really good with her, honesty’.

Staff supported people’s individual needs to ensure they experienced equity in outcomes. They were respectful of people’s beliefs and what was important to them. A staff member said, “They have their own religion and their own cultures. We respect them all. We help them in their own ways, how they want.”

Care records had been updated to include more information about people, their experiences and what was important to them. This helped staff to support the person and ensure they received equity in experience and outcomes that were personalised to their preferences.

When applicable, plans were in place to discuss people’s plans for the future. One person told us, “I have done an end-of-life form that I had to sign, I think my [relative’s] got it. I signed a form to say if had to be resuscitated don’t do it.”

The staff we spoke with told us they were not currently supporting anyone with end-of-life care, but they had received training on this and they were well supported by their managers when they were working with someone who was nearing the end of their life.

Care records included details about people’s plans for the future and how they wanted to be supported.