Prime 4 Care Ltd

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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

The provider did not have effective systems and processes to manage and oversee the quality of service. Last time we found a breach of regulation. At this assessment, that breach remained. The provider had no systems in place to record any completed quality checks so we were unable to review what they had checked. Since the last inspection, the provider introduced a new electronic call system to manage care calls. Staff felt supported by the provider and were able to raise any questions or concerns.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was limited evidence of learning since our last inspection. The provider and manager were open and honest to us where gaps in their knowledge, records and systems existed. There was a willingness to learn and improve. The provider did welcome and support an open culture which was supported by staff feedback to us. Staff were confident to call out poor practice, confident those concerns would be actioned. Staff said they worked well, within a consistent staff team on care calls. Staff felt the management of the service was good.

The provider was proud of the support and difference they made to people, however, this was not evidenced. There were no processes to identify any issues at the early stages to minimise any possible impact on people or the service. Some processes for feedback included people's satisfaction surveys and observed staff practice to ensure staff delivered a good service.

Staff knew their roles, responsibilities and how to support each other. The manager and provider were open, honest and supportive to staff. Management invested in staff training and supported all staff. Staff told us they felt the servcie was well managed and if they needed anything, the provider was supportive.

The manager told us they wanted good staff, but not everyone could drive. The provider employed drivers who take some care staff to care calls. The manager recognised it was important to get the calibre of staff they wanted and then set about identifying how they could support them.

Staff felt confident to report, whistle blow and raise concerns if needed. Staff were positive about the management who were open, listened and acted upon feedback. One staff member said their training included safeguarding and how to keep people and themselves safe. One staff member said in the past they had raised an issue and it was dealt with successfully.

Provider had processes to inform staff how to whistle blowing, learn from incidents and improvement through feedback and observed staff practice. Staff were able to raise concerns and have their practice observed to ensure any training and learning was applied.

Staff told us their preferences were met, for example, supporting people closer to their home. One staff member told staff were where practical, matched to people, for example, if a person spoke a particular language or if a person wanted a male or female. Each staff member respected those they worked with, and those they supported.

There were processes for staff recruitment and induction. Staff received training relevant to their roles. The manager said new staff received a full induction and staff were considered for reasonable adjustments – such as considering travelling between calls/geographical areas.

The manager and provider told us they had improved since the last inspection. The manager said they had begun to embrace new technology to help them plan care calls, complete audit and have more control of the care call planning system. The manager told us they checked care plans, risk assessments, medicine records and care call timings. However, the issues we found had not been identified through any audits or checks. The manager accepted this was not good and committed to improving their systems.

At the previous inspection the provider was in breach of the legal regulations of good governance. At this assessment we found limited improvement and the legal breach ‘good governance’ continued so they remained in breach of this regulation. We could not reference what the provider told us because the provider failed to keep any records of what was checked, and they could not give us any records of checks. The issues we found had not been identified by them.

A relative told us a district nurse supported their family member with their skin integrity. Care staff supported people before and after hospital appointments and relatives and people were complimentary of that support. People and families said communication and how that information was provided was good. People, and with consent, their families could have access to the electronic care planning system so they can maintain regular oversight of the care and support provided.

Staff told us they could make any referrals to health professionals via office staff. Staff told us if health professionals were involved, they were kept informed and any changes were communicated to them.

We asked health professionals for their feedback. We did not receive any feedback, however, conversations with a relative and the provider, showed health partners had been involved, consulted with and in some cases, the provider supported families at meetings. A relative we spoke with told us how important this was to them and how this was appreciated. This showed health professionals were involved when required.

Evidence from a relative and the manager demonstrated the provider worked close with health agencies, families and people they supported. Technology included use of an electronic care call system to allocate and monitor care calls. Further technologies would include electronic care planning and the ability to improved sharing of information.

The manager and director told us they had learnt from previous inspections and had recently addressed some improvements to managing care calls. Staff felt improvements had made for them to have better days at work and staff felt part of a team. Use of technologies to manage and monitor care calls had improved the service people received. One staff member said with more electronic systems they would be able to better share information with other health professionals.

Despite the manager and provider being confident they had learnt from previous inspections, we found processes did not record or demonstrate people’s care information remained relevant and accurate for staff to follow. Learning from previous inspections was not always evident because a previous legal breach remained. The manager and provided wanted to drive the improvements and said they were committed to do this.