20 November 2023
During an inspection looking at part of the service
Premium Homecare is a domiciliary care agency providing personal care to people in their own home. At the time of our inspection there were 107 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.
People’s experience of the service and what we found:
The provider’s systems did not always effectively monitor the quality of care provided to drive improvements. At the time of our inspection there were not sufficient systems in place to ensure the registered manager had appropriate oversight of all areas of service delivery.
The electronic systems for care records and call scheduling was also not fit for purpose. We found complete, accurate and contemporaneous records were not maintained in regard to people’s care needs or risks to their health and welfare. Staff had not always appropriately assessed risks to people’s safety.
Whilst the registered manager was aware of and had started to make changes, at the time of our inspection we found people experienced late visits, insufficient planning for those people who required support from 2 care workers and insufficient travel time between calls.
Safe recruitment practices were not in place to ensure suitable and competent staff were employed.
People were happy with the support they received and had developed good relationships with their regular care worker. People felt safe and comfortable with their care worker. Systems were in place to safeguard people from avoidable harm. Adequate systems were in place for the administering and management of medicines. Good infection prevention and control procedures were in place. Individual incidents and complaints were managed appropriately. People, relatives and staff felt comfortable speaking with the registered manager and office staff. They felt any concerns raised were listened to and dealt with.
The registered manager was working well with the local authority and were making progress on their agreed action plan. The provider was in the process of purchasing a new electronic call monitoring and recording system which would enable them to have clearer monitoring and oversight of key information.
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 6 August 2021)
Why we inspected
The inspection was prompted in part due to concerns received about poor timekeeping for visits, complaints management and risks relating to safeguarding matters. A decision was made for us to inspect and examine those risks. 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.
Enforcement
We have identified breaches in relation to safe care and treatment, staff recruitment and good governance.
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.