Premier Community

Updated 14 January 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

This inspection was carried out by an inspector and 3 Expert’s by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

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 were 3 registered managers in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 21 October 2022 and ended on 10 November 2022. We visited the location’s office 2 November 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 40 people who used the service and their relatives. We spoke with and sought feedback from 40 members of staff, including the 3 registered managers, care staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received feedback from 2 healthcare professionals who worked with the service. We reviewed records relating to people’s care, staff training and governance of the service.

Updated 14 January 2023

About the service

Premier Community is a domiciliary care agency providing personal care to people in their own homes. They support older adults with a range of physical and mental health needs. At the time of our inspection there were 393 people using the service.

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.

The service is split into 3 areas, each individually managed. The areas are Nottinghamshire, Derbyshire North West and Derbyshire North East.

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

Feedback we received for Derbyshire North West and Nottinghamshire raised several concerns. However, feedback about Derbyshire North East was more positive.

People did not always receive their calls at their preferred or even scheduled times. Calls were often condensed or cut due to staffing demands and people’s needs were not always all met as a result.

People did not always receive care in a person-centred way and care plans were not always being kept up to date to reflect people’s current needs and requirements.

People were supported to take their medicines although not always in a timely way and recording was not always in line with best practice.

We have made a recommendation around medicines management.

People experienced a lack of communication from management. Staff also felt they were not being supported. The provider did have systems and processes in place to monitor the quality and care delivery of the service, however these had not proved effective in improving the service. The provider was aware of some of the concerns and had taken measures to ensure people’s experiences improved.

People told us the carers were kind and treated them well. People felt safe whilst being supported by them and staff knew how to protect people from risks and abuse.

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

Rating at last inspection

The last rating for this service was good (published 31 May 2019).

Why we inspected

We received concerns in relation to call timings, missed calls and a lack of response to raise concerns. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to staffing, delivering personalised care and governance. We also made a recommendation about medicines management and documentation.

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

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.