Prema Court

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified 1 breach of regulation in relation to the systems in place for governance, as systems for oversight were not being used effectively to identify areas for improvement and ensure appropriate action was taken and embedded. Audits had not been completed since January 2024. Actions identified in audits and external risk assessments had not been completed in a timely way. Issues with the buildings maintenance and décor had not been addressed. Quotes had been obtained for some work, but then these had not been authorised by the provider. Staff spoke positively about the home manager and felt supported. However, felt head office management were not always supportive and didn’t provide the resources to maintain and improve the buildings. Partner agencies had a service improvement plan in place to ensure improvements were made.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff said they felt supported by the registered manager; however, they did not feel there was support from the head office management team. Some staff said they felt at risk from the provider if they raised their concerns or issues. Care staff were not aware of the recovery star model for supporting people with mental health needs. Seniors held regular one to one meetings with people to discuss their mental health and support. However, the care staff were not involved in supporting people towards their recovery star goals. Staff interacted well with people throughout our inspection.

We were told staff meetings were held but no minutes were seen.

Staff said the registered manager was approachable and supportive. However, they felt that maintenance issues, including the garden, had not been completed due to head office not providing the funding needed. The registered manager said they felt well supported by the new area manager and operations manager. This support had improved since they had been appointed. However, the providers leadership had not ensured the home had been properly maintained. Necessary improvements in the home, from safety issues such as fire doors to general maintenance and décor, for example damaged flooring and bathrooms, had not been completed. Quotes had been obtained for some jobs and then not actioned by the provider / head office.

The home had not had a full management team in place since January 2024. The registered manager had managed the service, as well as supporting a sister service, on their own. A team leader had been appointed and a second team leader was being sought to support the registered manager. This had affected the registered manager being able to complete their audits and checks as planned. Our assessment of process indicated further work was need to support the manager in their role and ensure there were robust systems for oversight which were effectively used

Staff said they felt supported by the registered manager; however, they did not feel there was support from the head office management team. Some staff said they felt at risk from the provider if they raised their concerns or issues.

Records did not always reflect effective processes were being completed, for example that regular meetings were happening.

Staff said the registered manager treated them all fairly. The home had a diverse workforce, with different ethnicities.

Records did not always reflect effective processes were being completed, for example that regular meetings were happening and there was insufficient oversight of staff training and supervision.

Staff recognised that there was work needed on the building and environment. They also said improvements had recently been made, with deep cleans of the kitchens completed and fire doors being fitted. Quotes had been obtained for some jobs and then not actioned by the provider’s head office. The registered manager acknowledged that audits had not been completed in the last 4 months and identified actions had not been completed in a timely way. There was no deputy manager in place since January 2024 to support the registered manager. We were told instead of a deputy being recruited, a team leader had been appointed and a second team leader was to be recruited. They would support the registered manager and cover the home across all 7 days between them.

Processes to ensure governance and oversight were not effective. Audits had not been completed since January 2024. Actions identified in audits and external risk assessments had not been completed in a timely way, for example the fire doors not being replaced following the 2020 fire risk assessment. A monthly report to head office had also not been done since January 2024. The report was being changed by the operations manager but had not been done while it was being reviewed. Safeguarding and incident trackers had not been completed. In January 2024 the monthly managers’ report states a monthly deep clean of the kitchens had been done, but by April the kitchens were very dirty, and an external contractor was needed to clean them. No checks that the cleaning had been completed had been carried out. Legionella checks were completed by an external company. Issues were noted for over 12 months and not actioned. The registered manager said they were not aware of these issues. There had been little visibility or support for the registered manager from the head office. The deputy manager post had not been covered since January 2024, resulting in the registered manager not being able to complete all their audits and actions. The local authority said there was a lack of reporting to them about issues at Prema Court.

The service had links with a local primary school. The children planned to visit the service, however this depended on people’s mood on the day of the visit.

The registered manager said there were challenges in the relationship with some partnership agencies due to concerns they had about the home. Greater Manchester Mental Health Trust (GMMH) had recently started to review the support needs of people living at the home. Prior to this many people had not had a review for several years.

Concerns had been raised by the local authority regarding the management and oversight of the service. Fire safety measures had not been completed, no chef for a period of time impacting on the meals available, dirty kitchens, people’s appearance, general maintenance and appearance of the building. Some of these issues were being addressed with fire doors being installed, a new fire alarm system due to be fitted, a chef has been employed, a deep clean of the kitchens completed and fridges, freezers and dried food stores being fully stocked. The local authority said not all issues were reported to them by the service.

The service worked alongside a variety of agencies. There were areas where partnership working needed to be improved.

The registered manager was part of the local authority provider forum, so information could be shared by the local authority and experience gained from other registered managers in the area. However, necessary improvements in the home, from safety issues such as fire doors to general maintenance and décor, for example damaged flooring and bathrooms, had not been completed. Quotes had been obtained for some jobs and then not actioned by the provider.

Audits had not been completed since January 2024. Actions identified had not been completed. Safeguarding and incident trackers were not being updated. A service improvement plan had been put in place by the local authority following their site visits to address the shortfalls they found and support ongoing learning and improvements