Prime Care Support Limited

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People’s care records did not always fully document the support they needed or what support other professionals were currently giving them, making it harder for people to have effective consistent support. However, people’s needs were thoroughly assessed when they started using the service. The staff team worked well together and worked well with other professionals to support good health outcomes for people. People were supported within the principles of the Mental Capacity Act (MCA).

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us their needs were assessed before using the service. A relative told us ‘‘Before [family member] started using the service [management team] came and had a chat with us. It was quite thorough and covered what was important to [family member].’’ They also told us if they had changes to their support needs, they would tell the staff and management team so these new needs could be assessed. One person said, ‘‘I had [change in support needs] a few months a go but it was just a quick discussion with [management team] and they put more visits in place for me. No worries.’’

Staff told us they were supported to get to know people who were new to the service because assessments were completed, and care plans were in place for them to read beforehand. They were also supported to shadow other staff members who knew people well before they started supporting them on a regular basis. The registered manager and management team spoke with us about their assessment process and the importance of getting this right at the start so staff could support people as well as possible.

The processes in place to assess people’s support needs were robust and effective. However, on occasion changes to people’s care needs were not always recorded and reported to the management team in a timely fashion. For example, staff recorded a person had a change in their support needs throughout daily records however, it was unclear when this change happened or what support the person now needed. This had not been updated in the persons support plan. We fed this back to the registered manager who assured us and sent us evidence this had been addressed and improvements were made to help ensure this did not happen again.

People felt staff knew how to support them in line with their support needs. One person said, ‘‘I see the same staff most of the time and I can see how well they have been trained. They know how to help me.’’ A relative told us, ‘‘I think the management team keep staff up to date with how best to help [family member].’’

Staff spoke with us about how they were supported to have training relevant to their job roles and the support people needed. For example, staff had training in supporting people living with dementia, living with learning disabilities and autistic people. They spoke with us at length about the impact this had on them and how it informed them how to support people in line with best practice. The registered manager and provider told us how they kept up to date with best practice guidance and shared this with the staff team.

Processes were in place to support people with best practice guidance. For example, the registered manager and management team attended workshops with other professionals to stay up to date with guidance. Evidence based care and treatment was added to policies and procedures in place at the service to help ensure staff supported people in line with best practice.

We received some mixed feedback from people and relatives about how well staff worked with one another if people did not have a consistent staff team. For example, one person said, ‘‘Some staff are really good and know me well, but they must not tell [unfamiliar staff] how to do things because they are not as good.’’ A relative told us, ‘‘It is frustrating when some staff do things differently. It would be good if they all did the same thing and followed the care plan.’’ Some people also told us how they would have visits from professionals such as district nurses but were not sure whether staff knew about this. A relative said, ‘‘The issue is that [family member] has quite specific support needs and has a lot of input from [professionals]. However, sometimes the staff do not seem to know these have happened. I have had to tell staff about appointments before and I would expect this to be written down somewhere.’’ We also received positive feedback about how staff worked together. One person said, ‘‘The staff are a great bunch of people, and you can see they get on well.’’ A relative told us, ‘‘[Staff] are always relaxed and friendly with each other which helps [family member] feel at ease with them.’’ People and relatives also told us how staff members worked well when advice was given about their support by professionals.

Staff were very positive about how well they worked together and told us they enjoyed supporting one another. This had resulted in a positive working environment where staff helped one another to make sure the service ran smoothly, and people got the support they needed. They also told us they took note of any advice professionals gave about people’s support and considered this if it resulted in a change to people’s needs. The registered manager and staff team were proud of how they supported the staff team to work well together and also with them. Staff gave positive feedback about how they worked with the management team.

Professionals who supported people told us they felt staff and management worked well with them and followed their advice to help support good outcomes for people. One professional said, ‘‘[Staff] are very keen to follow the advice we put in place, and we never have any concerns when we check to ensure the support is in place after we visit.’’

Processes were in place to support staff and other services to work well together. However, in some cases these processes were not always effective. For example, staff did not always record visits from professionals or their advice on people’s daily records. This made it more difficult to update people’s care plans if their needs changed. The registered manager acted immediately on these concerns and also showed us evidence they would put more audits and checks in place to help prevent this happening in the future. In other cases, processes enabled effective working between the staff team and other services. Advice from other services was detailed in people’s care plans. Where possible processes were in place to support staff to work together when supporting people on as consistent basis as possible. This helped enable them to support each other and work well together.

People and relatives told us staff supported them to be healthy. One person said, ‘‘[Staff] know how important it is for me to [eat amount of food] and to have a drink when they visit me. They know [health conditions] do impact me but try their best to keep me moving as well.’’ A relative told us, ‘‘[Staff] always make sure [family member] has something to drink. They try and keep them independent when they support them, so they keep [mobility skills] as well.’’ People and relatives also told us staff would contact professionals such as GPs if they were concerned and on occasion changed their working patterns to support people to appointments.

Staff were knowledgeable about how to support people to be healthy and knew the importance of offering regular food and drink. Staff spoke in detail about people’s specific support needs in relation to their health conditions and what they needed to do to help ensure the person stayed healthy. The registered manager and provider evidenced to us that they gave staff the opportunity to learn about and be proficient in supporting people living with a wide array of support needs.

Processes were in place to support people to live healthier. However, sometimes these were not completely effective. For example, staff would not consistently record how a person who had a pressure sore was progressing. Staff would record a person had a pressure sore, however this would then not be mentioned or recorded on for several days. This made it difficult to see if the person was remaining healthy or if they needed more support. We also noted several gaps in relation to staff recording how much food people were eating and drinking when this support needed to be recorded. The registered manager acted immediately on this feedback, holding workshops to discuss recording with staff and strengthening the way in which care recorded were audited. This assured us improvements would be made and sustained. In other cases, processes were efficient in supporting people to live healthier lives. People’s care plans gave a good number of details about health-related support needs and the best way to support people to be healthy was discussed regularly with the staff team.

People and relatives told us staff supported them to monitor and improve their health-related outcomes. One person said, ‘‘[Staff] are well trained and know how to help me with [support need]. Not sure what I would do without them.’’ A relative explained, ‘‘Since [family member] has started using the service they have come on leaps and bounds. I think the staff do a great job.’’

Staff told us how they supported people to achieve health related outcomes by ensuring they gave them the right support in line with their assessed needs and the guidance in their care plans. The management team shared evidence with us of how they had supported people to achieve positive health related outcomes.

Processes were in place to support people with their health-related outcomes. However as mentioned in the previous quality statements, staff did not always consistently record people’s health needs in relation to areas such as eating and drinking, medication being administered or pressure sores. This had the potential to impact how well supported people were as changes to their support needs may not be documented correctly. The registered manager acted immediately on this feedback, holding workshops to discuss recording with staff and strengthening the way in which care recorded were audited. This assured us improvements would be made and sustained. Despite these finding's these processes also worked well. Where staff recorded people’s support in daily records, it was clear people’s outcomes were being met.

People told us staff asked for their consent when they supported them. One person said, ‘‘[Staff] are very polite and always let me know what they are doing.’’ A relative told us, ‘‘[Staff] know how [family member] likes to be supported but they always ask them anyway. They are very respectful.’’

Staff had training in the Mental Capacity Act (MCA) and knew how to apply this in their job roles. They were very knowledgeable about this. The registered manager and management team discussed the MCA with staff regularly and checked their competency when it came to their understanding of the MCA when supporting people.

Where people lacked capacity, assessments were completed, and decisions were made in their best interests. Discussions involved people and those important to them as well as relevant professionals to help ensure decisions were made in people’s best interests. The management team also checked staff were following the principles of the MCA when they completed spot checks of them supporting people.