Prestige Home Care

On this page

• 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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The service was in breach of legal regulation in relation to governance and oversight at the service.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives spoke highly of the registered manager. People and relatives agreed the staff and the registered manager showed a positive and compassionate culture that supported people, their relatives and staff. People and relatives said, “The manager is totally understanding of our situation. She is compassionate and very helpful. There seems to be a very a positive culture in the service”, “The manager is lovely, we get on very well”, “The interaction with the manager is very good.”

“All I know is [the person] gets good care and that comes from good management” and “They are positive and compassionate. Other agencies could learn from them”. The registered manager and the staff team demonstrated a shared responsibility for promoting people's wellbeing, safety, and security. The staff team and the registered manager used regular daily communication to share and discuss any matters or what was going on in the service. Any changes were discussed together with staff and/or other relevant parties to make those changes. The registered manager praised their staff team for positive engagement and added, “I feel very supported by the staff team and I hope they feel the same about me. People felt supported by the staff, they do great job. If I need support, staff are always willing to help and I do the same. They are a very good team and they work very well together.” The registered manager worked with staff to ensure equality and diversity were promoted, and the causes of any workforce inequality were identified, and action was taken to address these. Provider had process in place deal with changes of business continuity such staffing, IT or weather issues.

The registered manager and staff worked together to promote people's wellbeing, safety, and security. People and relatives said staff were happy working at the service. They noted staff were “always smiling and happy when visiting people’s homes”. Staff added, “Yes,[managers] are kind and caring. Managers do spot checks on staff to make sure things are good” and “The company is very good. It is a good place to work…It meets people’s needs at all times.” The staff team were motivated to provide care and support to people as their needs and health were changing. The registered manager told us how they promoted a positive, caring, transparent and inclusive culture within the service. The registered manager and other senior staff were visible to the staff team, people and relatives, and professionals. The registered manager added, “We have conversations in the office about the service and any issues. We keep an eye on staff’s practices and what needs doing”. The registered manager added they felt supported by the provider and the staff team to ensure people continued receiving care and support they needed. Staff felt listened to, supported and the registered manager was approachable. Staff worked together well and were positive about the leadership in the service that contributed to better outcomes for people, their relatives and staff team.

The staff told us they knew how to, and felt confident, speaking up and sharing any concerns with the registered manager. The registered manager fostered a positive culture where people, their relatives and staff felt that they can speak up and that their voice will be heard. The registered manager added, “We are welcoming, we are open and easy to talk to. We encourage staff to share any information with us, whatever it is. We also ask in supervision about variety issues they may have and to share with us to address it.” When concerns or issues were raised, the registered manager and staff worked together to review and address those. People and relatives felt comfortable speaking to the service and felt they were listened to. They felt the service was pro-active in finding solutions. People and relatives felt the service would apologise if something went wrong and try to rectify it. People and relatives said, “Very open culture. No doubt they would apologise if a problem occurred”, “If something went wrong, they would be the first to admit it and apologise”, “I could tell them anything” and “Oh I can talk to them alright. No worries there.”

The registered manager valued and respected diversity in the workforce. The registered manager continuously communicated with staff about the service or any other matters to ensure staff were included and valued. Staff were able to share ideas and were able to contribute to the service. Staff felt positive about the service and were confident to raise any concerns and ideas that could support the service. They felt supported, treated fairly and looked after by the managers. The registered manager also worked alongside staff delivering care at times which would help them understand any issues staff encountered. The working environment was inclusive, and staff’s wellbeing was considered. This ensured the service had a positive culture which supported better outcomes for people.

The registered manager and the provider did not always have effective governance system to identify issues we found during this assessment and that are described throughout the report. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The registered manager did not always monitor recruitment checks were carried out to ensure all required information was gathered to ensure there were suitable staff to work with people. We identified gaps in oversight of the required training which led to inconsistencies in learning, compliance, and skill development. Where we found issues with medicine management, this was not always identified during quality assurance checks. For example, oversight of medicine administration, PRN protocols and reviews of those, related records to ensure people received correct medicine, lack of details in risk management and care plans when people had their medicine left out for them. Improvements were needed to ensure effective audits of records and practice were carried out. We found in one person’s records showed a dose recorded incorrectly showing a potential overdose. The provider’s checks had not recognised this error and confirm it was a recording error.Care plans were regularly reviewed, however they were not always accurately updated to reflect peoples’ needs and requirements. For example, one person’s risks regarding environment and fire safety had not been updated when their needs changed to ensure staff had accurate guidance. Another person had to have thickened fluids due to risk of choking, but guidance was not clear how much to thicken fluids when using different cups or glasses and mitigate that risk. Systems did not always ensure incidents were reported to the local authority and/or CQC.

People benefited from the service that worked in partnership with different professionals to ensure people were looked after well. Where necessary, external health and social care professionals had been contacted for further support and advice, or kept up to date with developments. The registered manager told us how they worked with people, their families and professionals to ensure people received the care and treatment they needed. People and relatives agreed the service worked well with external professionals to support people’s health and wellbeing. Staff agreed things were going well and they worked with all relevant external stakeholders and agencies. One professional added, “[The service] work closely with us sharing feedback to help develop our services including attending provider forums and engagement events as well as training arranged by us. They are very responsive to emails and easy to reach if we have to including directors who are very closely involved. We have complaints or concerns with care services.”

The registered manager and the provider did not always have a clear process to focus on continuous learning and improvement from recorded events, audits and information across the organisation and local system. The registered manager gathered feedback from people and relatives, however the registered manager did not always analyse responses and compare those of what they did well, what needed improving or changing. Surveys were not completed for staff and professionals which could be used to support service development and any improvements needed. Whilst we did identify shortfalls during this assessment, the registered manager was responsive to our findings and acted on key areas of improvement.

Staff had staff team meetings to discuss any items arising from running of the service and feedback received was shared with the staff team to help running of the service. The registered manager had an open-door policy and would welcome any feedback to support the service. They worked with people, families and professionals to ensure people were able to achieve their goals and outcomes that had positive effects on people. The registered manager shared some success stories to note how they supported people to make improvements to their health and wellbeing that positively affected their lives. The service had good links with the local community and the provider worked in partnership with other agencies to improve people's wellbeing as necessary.