Prestige Nursing - Worthing

Updated 7 November 2019

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 Care Act 2014.

Inspection team

The inspection team consisted of one inspector and one Expert 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection because we needed to be sure that staff would be available to support the inspection and to let people know that an inspector might contact them.

Inspection activity started on 24 September 2019 and ended on 25 September 2019. We visited the office location on both these dates and we spoke with people or their relatives by telephone.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 13 people who used the service about their experience of the care provided. We spoke with eight members of staff including the registered manager and the business manager,

We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 7 November 2019

About the service

Prestige Nursing - Worthing is a domiciliary care service providing personal care and support to people living in their own homes. The office is based in Worthing and the service currently provides care and support to people living across West and East Sussex. At the time of our inspection there were 126 people using the service. People's packages of care varied depending upon the level of their needs. Some people had complex needs and the service was provided to both adults and children.

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

Management systems were not being used consistently to support governance and oversight of the service. This meant that there was a lack of analysis to identify patterns and trends overtime, leading to lost opportunities for driving improvements. There was an over-reliance on verbal communication which meant that some records were not always complete to show how decisions about care and treatment had been made. We made a recommendation that the provider undertakes a review of their management systems.

People and their relatives told us that they continued to be happy with the care and support they received. Their comments included, “I like Prestige, I think it’s well run,” and, “ The service they provide is excellent, very reliable and often with the same carer. I’ve had good information from the start.”

Staff understood their responsibilities for safeguarding people. Risks were identified and managed and risks were reviewed regularly, including following incidents and accidents. People who needed support, received their medicines safely. There were enough suitable staff to provide the care visits that people needed. Staff understood how to protect people with the prevention and control of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had received training that was relevant to people’s needs and felt supported in their roles. One staff member said, “The staff are well looked after here and they feel valued.” People told us they had confidence in the skills of the staff. People’s needs had been assessed in a holistic way. Where needed, people were supported with eating and drinking and to access health care services.

Staff knew the people they supported well and had developed positive relationships with them. People told us they felt respected and were treated with kindness. One person told us, “ I have the most brilliant main carer. Some of the other regular carers are also outstanding, they go the extra mile to show they really care.”

People were receiving a personalised service. Some people had complex needs and their care plans were comprehensive and detailed. People told us they felt in control of their care. One person said, “My original assessment arranged what care I would need and I still feel it’s my say how I want my care time to be used.” People knew how to complain and felt confident that concerns would be addressed. People were supported with end of life care.

People spoke highly of the service they received, the staff and the management of the service. One person said, “It’s a well-run and caring service.”

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 01 March 2017).

Why we inspected This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the Well Led section of this full report. We found no evidence during this inspection that people were at risk of harm from this concern.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.