We carried out a review of the data available to us about Prime Homecare on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Prime Homecare, you can give feedback on this service.
Prime Homecare is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides care and support to people which include personal care, food preparation and medicines support. At the time of this inspection, the registered manager informed us that they were providing care and support to 42 people. The Care Quality Commission (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
Improvements to medicines management systems had been made. Management had acted on previous concerns and implemented systems and processes to help ensure people received safe quality care. Appropriate medicines management and administration processes were in place.
Feedback indicated that people were satisfied with the care and services they received. People felt safe in the presence of care workers. They were complimentary about how the service was managed.
People were protected from abuse. Staff had received training on how to safeguard people.
People were supported by care workers they knew, who arrived on time and stayed their full allocated time. Recruitment processes ensured that care workers assessed as safe to work with people were employed.
Risks to people were assessed and managed, this helped the service deliver care in a safe way.
Accidents, incidents and safeguarding concerns were reported, investigated and recorded appropriately.
Suitable infection control practices helped to prevent and control the spread of infections including COVID-19.
Staff told us they were well supported by management. They were confident that management would listen and address any concerns if they raised them.
Quality checks monitored the care and support provided to people so that improvements to the service were made when deficiencies were identified. Management monitored aspects of the quality of the services through audits and checks.
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 (published 4 December 2020) and there was one breach of regulation. 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 regulation.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
My Homecare North West London is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides care and support to people which include personal care, food preparation and medication support. At the time of this inspection, the registered manager informed us that they were providing care and support to 50 people who used the service.
Not everyone using My Homecare North West London receives a regulated activity. CQC only inspects the service received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
People’s experience of using this service and what we found
The systems in place to manage people’s medicines were not able to show that people were supported to manage their medicines safely. We could not be assured that people were receiving their medicines as prescribed. We found a breach of regulation in respect of this.
Feedback from people who used the service and relatives was consistently good. People told us they felt safe when being cared for by care workers and this was confirmed by relatives we spoke with. People and relatives were complimentary about care workers and said they were caring, patient and respectful. They also told us that the service was professional and well run.
Systems were in place to help ensure people were protected from the risk of abuse. There were appropriate policies in place. People were protected from abuse by staff who understood how to identify and report any abuse concerns.
Assessments were carried out to ensure people's needs could be met. Where risks were identified, there was guidance in place for staff to ensure that people were safe.
Staff followed appropriate infection control practices. These practices were updated to reflect COVID-19 and systems in place.
There were appropriate numbers of suitably skilled staff available to meet people's needs. Feedback indicated that care workers were generally punctual.
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.
A system was in place to record and respond to accidents and incidents. Lessons learnt were used as opportunities to improve the quality of service.
There were systems in place to assess and monitor the quality of the service provided.
Rating at last inspection
The last rating for this service was Good (published 21 February 2019).
Why we inspected
This inspection was initially carried out as part of a pilot exploring virtual approaches to inspection. However, during the course of the inspection we identified concerns with medicines management. This meant that under the terms of the pilot we needed to convert the inspection to one that included a site visit. We carried out a site visit on 6 November 2020. This inspection was a mixture of a focused inspection and a targeted inspection.
This inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. We have identified a breach in relation to the safe management of medicines at this inspection.
You can see what action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Not everyone using My Homecare North West London receives a regulated activity. CQC only inspects the service received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.
The last comprehensive inspection we carried out in December 2017 found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment. The service failed to provide adequate risk assessments which included guidance to care workers for managing risks to people who used the service. During this inspection in January 2019, we found that the service had taken action to comply with the requirement. The service had the required risk assessments in place to provide guidance for care workers and ensure the safety of people. For example, the care records of a person who had diabetes contained a risk assessment with guidance on action to take if they became unwell or had hypoglycaemia or hyperglycaemia. In the case of epilepsy, there was guidance regarding ensuring people were kept safe when having a seizure.
At the last comprehensive inspection we found that the service did not have sufficiently effective quality assurance systems for fully assessing, monitoring and promptly improving the quality of care provided for people. We recommended that the service regularly audit progress and action taken to ensure that deficiencies are promptly identified and rectified. During this inspection we found that the service had taken appropriate action. The service had a system of regular checks to ensure people received the care they needed. Regular audits had been carried out since the last inspection. Where deficiencies were identified, the service had taken action to improve deficient areas. We further noted that the monitoring report of a local authority indicated that the service had made improvements and no significant concerns were identified.
We received positive feedback from people and relatives of people who used the service. They spoke highly of care workers and informed us that they were satisfied with the care and services provided. They informed us that people had been treated with respect and they were safe when cared for by the service.
The service had a policy on ensuring equality and valuing diversity and was committed to anti-discrimination and upholding the human rights of individuals. Care workers recognised the importance of treating people with dignity and respect. There was a safeguarding adults’ policy and care workers were aware of the procedure to follow if they suspected people were being abused.
The service had a policy and procedure for supporting people with medicines. The registered manager told us that care workers did not administer medicines but only prompted people to take their medicines. We noted that medicines support training had not been provided by either a pharmacist of healthcare professional. This is needed to ensure that care workers are provided with appropriate training by professionals with current knowledge of medicines. We have made a recommendation in respect of this.
The service had a recruitment procedure to ensure that care workers recruited were suitable and had the appropriate checks prior to being employed. We examined a sample of seven records of care workers. We noted that these records had the necessary documentation such as a Disclosure and Barring Service check (DBS), references, evidence of identity and permission to work in the United Kingdom.
The service had a training programme to ensure care workers were able to care effectively for people. Certificates were seen in the records of care workers. Care workers had the necessary support and supervision from management staff. Teamwork and communication within the service was good. New care workers had been provided with a comprehensive induction programme to equip them for their duties.
Care workers were caring in their approach and able to form positive relationships with people. There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided. Individual assessments and care plans had been prepared for people. The care documentation included information regarding people’s individual preferences, their cultural and religious background. Regular reviews of care had been carried out to ensure that people received appropriate care.
The service had a complaints procedure and people and their representatives knew who to contact if they had concerns. Complaints recorded had been promptly responded to. Feedback received in monitoring forms and in their 2018 satisfaction survey indicated that people and their representatives were satisfied with the management of the service.
Not everyone using My Homecare North West London receives regulated activity; CQC only inspects the service received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.
We received positive feedback from people and relatives of people who used the service. They spoke highly of care workers and informed us that they were satisfied with the care and services provided. They informed us that people had been treated with respect and they were safe when cared for by the service. There was a safeguarding adults’ policy and care workers were aware of the procedure to follow if they suspected people were being abused.
The service had a policy and procedure for the administration of medicines. The nominated individual told us that care workers did not administer medicines but only prompted people to take their medicines.
Risk assessments were seen in the care records of people. However, they were not sufficiently comprehensive as they did not inform care workers of what specific risks or problems may be experienced by people concerned and how to keep people safe. For example, there was no mention of risks of hypoglycaemia or hyperglycaemia for someone with diabetes. In the case of epilepsy, there was no guidance regarding ensuring people were kept safe when having a seizure. One person who displayed behaviour which may challenge the service did not have a risk assessment. The required risk assessment for this particular person was provided soon after the inspection. We have made a requirement in respect of this. The nominated individual stated that they would ensure that the required risk assessments were provided.
The service had a recruitment procedure to ensure that care workers recruited were suitable and had the appropriate checks prior to being employed. We examined a sample of six records of care workers. We noted that these records had the necessary documentation such as a Disclosure and Barring Service check (DBS), references, evidence of identity and permission to work in the United Kingdom.
The service had a training programme to ensure care workers were competent and able to care effectively for people. Certificates were seen in the records of care workers. They had the necessary support and supervision from management staff. Teamwork and communication within the service was good. New care workers had been started on a comprehensive induction called The Care Certificate.
Care workers were caring in their approach and able to form positive relationships with people. There were arrangements for encouraging people and their representatives to express their views and make suggestions regarding the care provided and the management of the service. Individual assessments and care plans had been prepared for people. However, the care documentation lacked information regarding people’s cultural and religious background. After the inspection, the registered manager provided us with their new format for recording this information. Reviews of care had been carried out to ensure that people received appropriate care.
The service had a complaints procedure and people and their representatives knew who to contact if they had concerns. Complaints recorded had been promptly responded to. People and their representatives expressed confidence in the management of the service.
The registered manager stated that an audit of the service had been carried by the franchisor several months previously. We however, noted that there was no documented evidence of this or any other regular audits. We saw no written evidence of regular audits in areas such as complaints made, policies and procedures, care documentation and training. Comprehensive audits are needed so that the service can identify and promptly rectify deficiencies. We have made a recommendation in respect of this.
The registered manager informed us that the service was newly set up and they were in the process of arranging their audits.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we told the provider to take at the back of the full version of the report.