Date of Assessment: 28 October 2024 to 6 December 2024. The service is a Domiciliary Care Agency (DCA) registered to provide personal care. People were supported with their personal care needs to enable them to live in their own homes and promote their independence. At the time of the assessment the service supported 131 people with personal care. At our last inspection the service was in breach of regulations in relation to staffing, delivering personalised care and governance. The service had made improvements and is no longer in breach of regulations. People were now supported by trained and knowledgeable staff and the service employed a suitable number of staff to ensure people received their care calls consistently and on time. This was further supported using a team of trained bank staff to cover in the event of staff sickness or annual leave. The provider had effective quality monitoring systems in place to identify and drive improvements. Managers investigated incidents thoroughly and followed up on any additional actions to maintain people’s safety in their own home. People knew how to give feedback and were confident the service took it seriously and acted on it. Managers and care coordinators were visible, knowledgeable and supportive, helping staff develop in their roles. People were supported by staff who felt valued by the management team. Staff consistently told us they were supported, trained and encouraged to deliver person centred care in line with peoples wishes.
PDF cached but not yet analysed by Claude; set ANTHROPIC_API_KEY and re-run npm run etl:reports -- --location 1-213682363.
Premier Community, a domiciliary care agency serving 393 people across three areas in Nottinghamshire and Derbyshire, was rated Requires Improvement overall following a focused inspection of Safe, Responsive and Well-led domains, with breaches found in Regulations 9, 17 and 18 relating to person-centred care, governance and staffing respectively. Key failures included persistent late and shortened visits, outdated care plans, ineffective quality monitoring and poor management communication, though the Derbyshire North East area, safeguarding practices and infection control were noted as relative strengths.
Concerns (13)
criticalStaffing levels: “The provider had failed to ensure they had enough suitably trained staff to deliver care as planned. This was a breach of regulation 18 of the Health and Social Care Act 2008.”
criticalMissed or late visits: “The carers are never on time, they can be late or early. I've had numerous meetings with the agency about it. They say they can't do anything about it as they are understaffed.”
criticalPerson-centred care: “The provider failed to ensure care was planned and delivered in a personalised way. This was a breach of regulation 9 of the Health and Social Care Act 2008.”
criticalGovernance: “The provider failed to ensure they had effective quality monitoring measures in place, failed to act on feedback received and failed to ensure they kept complete and contemporaneous records.”
moderateMedication management: “People who were prescribed medicines which were time specific or required a set amount of time between doses were not always supported to take these as prescribed.”
moderateCare planning: “Care records were not always kept up to date to reflect people's current choices and requirements. I've sent concern reports in regarding changes that need to be amended on individual's care plans which don't get actioned.”
moderateRecord keeping: “Records we checked contained out of date information regarding people's medicines. Staff were not guided by the provider to record all types of medicine support.”
moderateSupervision / appraisal: “Staff told us they did not have regular supervisions and there were inconsistencies in the support they received from management.”
moderateComplaints handling: “If I try to ring the office I can't get to speak to the manager and if I email the office I get no reply. I have complained about timings of visits – they are never on time – but nothing improves.”
moderateCommunication with families: “We have no contact from the office, I phoned them once and they never called me back, so I don't bother now.”
minorStaff training: “Without in-person training I felt somewhat unprepared when I first started.”
minorIncident learning: “Staff told us they were not made aware of outcomes from concerns they had raised; therefore, we cannot be confident lessons were shared amongst the staff team.”
minorEnd-of-life care: “The provider had an 'end of life' policy in place which was well written, but in the records, we checked we found no evidence of the advised care planning around end of life having been put into practice.”
Strengths
· People felt safe with carers and staff knew how to protect people from risks and abuse; safeguarding processes were effective.
· Robust pre-employment checks including DBS checks were in place for safe recruitment.
· Risks associated with care delivery, environment and individual needs had been assessed and documented, including high-risk needs such as catheter care.
· Infection control measures were highlighted throughout care plans and staff wore appropriate PPE.
· The provider worked collaboratively with health and social care professionals, receiving positive feedback from professionals.