Prime 4 Care Ltd

Updated 31 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or service manager would be in the office to support the inspection.

Inspection activity started on 26 April 2023 and ended on 4 May 2023. We visited the location’s office on 26 April 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 staff including the Nominated Individual, the service manager and agency care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with 4 relatives for feedback on their experiences of the care provided. We reviewed 3 people's care records, medication records and recruitment checks. We also reviewed a range of documents relating to the management of the service including policies, procedures and the provider's new training programme.

Updated 31 May 2023

About the service

Prime for Care Ltd is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 7 people using the service.

People's experience of using the service and what we found

Although risks to people’s health and safety were identified, those risks were not routinely assessed or reviewed following changes to people’s health. Medicine administration records (MARs) were not always clear and or follow best practice guidance. All staff who worked at Prime 4 Care Ltd were agency. The provider was recruiting permanent staff which included some of the agency staff who currently worked at the service. Staff recognised the importance of keeping people safe from the risk of abuse and avoidable harm. Staff were provided with Personal Protective Equipment (PPE) to promote good infection control. The provider was committed to improving the service at Prime 4 Care Ltd and learning from the inspection.

Improvements were needed to ensure that people’s assessments were reviewed following changes in their health, to ensure they remained relevant and up to date. 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 manager recognised when people’s ability to make decisions for themselves was compromised. However, improvements were needed to ensure statements regarding people’s mental capacity were supported by mental capacity assessments. The provider was committed to ensuring staff were well trained and had invested in a new training provider, and system to monitor when staff training was completed, or due. When people needed help with their eating and drinking, or assistance to prepare meals, this information was recorded in their care plan. The provider, manager and staff worked in partnership with other healthcare professionals to meet people’s needs and in response to changes or concerns about people’s health.

Audits and governance processes to maintain oversight of the safety and quality of care were either not in place or operating effectively. We received positive feedback about the care provided, and staff felt happy and well supported working at Prime 4 Care Ltd. The provider and manager had an understanding of some of the types of events and incidents that needed to be reported to CQC. Since joining Prime 4 Care Ltd, the new manager had visited people in their homes to check they were happy with their care and whether any changes were needed. Both the provider and the registered manager were committed to improving the service, and recognised that further work was needed to develop and embed good governance systems. The provider and staff worked closely with other health professionals to improve outcomes for people's health and social care needs.

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 29 June 2022). 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 the provider remained in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

We carried out an announced inspection of this service on 3 May 2022. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve Good Governance.

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, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has remained requires improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Prime 4 Care Ltd on our website at www.cqc.org.uk

Enforcement

We have identified breaches in relation to Safe Care and Treatment and Good Governance at this inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.