Priority Plus Ltd was rated Good across all five key questions at its announced inspection on 23 March 2017, with 37 people receiving domiciliary care. The service demonstrated consistent staffing, effective safeguarding practices, person-centred care, and robust quality monitoring by an accessible management team.
Strengths
· People felt safe at home with consistent, regular staff who knew their needs and arrived on time.
· Staff demonstrated good safeguarding knowledge and clear escalation procedures.
· Medicines were administered by trained staff with management observation checks and record audits.
· Staff received induction, shadowing, regular supervision, spot checks, and ongoing training.
· People were treated with dignity, respect and had their independence promoted.
Priority Plus Ltd was rated Good overall at its November 2019 inspection, with four of five key questions rated Good, but Well-Led deteriorated to Requires Improvement due to ineffective auditing, medicines record gaps, incorrect provider names on care records, unsupported supervisor competency checks, and absent end-of-life care planning. The service demonstrated clear strengths in safeguarding, staffing, person-centred care delivery, and responsive complaint handling.
Concerns (8)
moderateGovernance: “The provider did not ensure appropriate governance was followed as records had a different provider name on care records.”
moderateMedication management: “We found gaps on a Medicines Administration Record for September 2019 used to show when people were supported with their medicines.”
moderateMedication management: “Medicines given 'as and when' needed did not have in place PRN guidance to ensure consistency between care staff.”
moderateStaff competency: “The supervisors who supported care staff were not having their competency checked regularly.”
moderateRecord keeping: “The MAR did not clearly define that all tablets were given.”
minorStaff training: “The registered manager told us care staff did not receive any training in end of life care.”
minorEnd-of-life care: “Care records did not show how people wanted to be supported at the end of their life as this information was not being gathered.”
minorCare planning: “Only religion and culture were being considered on people's care records. This meant where people may have other protected characteristic this information was not considered.”
Strengths
· People felt safe and care staff were trained to protect people from harm with appropriate DBS checks and references completed before appointment.
· Risk assessments were in place and trends from accidents and incidents were monitored by the registered manager.
· Sufficient staffing levels were maintained and people confirmed staff were always on time.
· Care staff followed infection control procedures and had access to personal protective equipment.
· People were supported to eat and drink, access healthcare, and liaised with other professionals such as SALT.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
safe: Using medicines safelyGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies and supporting people to live healthier livesGood
effective: Staff support: induction, training, skills and experienceGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and controlGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportRequires improvement
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Continuous learning and improving care and working in partnership with othersGood