Prestige Care & Support Ltd

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• 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

Robust quality assurance systems were not in place to ensure people received safe and personalised support and there was a culture of continuous improvement. Systems were in place for staff to raise concerns. The care service worked in partnership with external services to ensure people were in the best of health.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager told us they promoted a positive culture within the home. The registered manager had an open door culture and therefore support was always available for staff when needed. We received mixed feedback from staff about the culture of the care service. Some staff told us that they received support when required and were able to provide feedback about the service to the management team and felt listened too. However, some staff and relatives also told us that they had raised concerns such as with people’s care and records and this had not been addressed. Some staff also told us they were not listened too when they took concerns to the management team. Improvements would be required in this area to ensure action is taken and response provided when concerns were raised.

The services Visions and Aims placed people at the heart of the service. Service objectives were monitored through audits. However, we found that audit systems were not robust to ensure the visions and aims of the service was adhered too consistently and ensure there was an open and positive culture at the service where people, relatives and staff felt safe and listened too to ensure feedback can be provided.

We received mixed feedback about the management team when we spoke to staff. Some staff were positive about the support received. A staff member told us, “Yes, we have staff meetings, 1 in the morning and 1 in the afternoon. Feedback can be given and they do listen.” However, some staff also told us when concerns were raised, response or feedback was not provided to these concerns and when information was requested on care plans, this was not provided. A staff member told us, “No, they do not listen.”

The registered manager knew the service, people and staff well. However, some shortfalls remain with risk assessments, training, safeguarding and good governance, which would require addressing to ensure people always received safe care and support.

The registered manager told us that during the staff induction programme, staff are given the whistleblowing policy to read and that the safeguarding training also covers whistleblowing and how to report concerns. Staff were clear that the provider had systems in place for whistleblowing.

A whistleblowing policy was in place that included how to raise concerns both internally and externally, which allowed staff freedom to speak up. Staff feedback was also sought as part of supervisions and staff meeting.

Staff had no concerns in this area.

An equality and diversity policy was in place and staff had been trained in this area. Systems were in place for flexible working arrangements as shift plans showed staff were able to work flexibly. Systems were in place to record incidents towards staff and action taken to ensure staff were safe.

The registered manager told us that a number of audits were carried out to ensure the service was providing safe care to people. However, further improvements were required in the quality assurance systems to ensure people always received safe high-quality care at all times.

There was not an effective quality assurance system in place to identify shortfalls and act on them to ensure people were safe. Audits had been carried out on records and the running of the service, however these audits had not identified the concerns we found during the assessment such as with risk assessments and safeguarding processes. This was required to ensure safe care was being delivered at all times. Robust systems were not in place to ensure staff were trained in key areas to perform their roles effectively. This meant there was a lack of oversight in ensuring staff were trained to work with vulnerable people, which meant people may not consistently receive high quality care. Records were not always kept up to date. We found risk assessments relating to eating and drinking and manual handling was not accurate and missed vital information to ensure people received safe care at all times and minimise risk of significant harm.

The registered manager and staff told us they worked in partnership with health and social professionals to ensure people’s needs were consistently met where required. A staff member told us, “We work alongside district nurses in Havering and if we feel like the client needs an appointment, we refer to the office.”

We received no concerns from partners about the service.

Records showed the service working in partnership with social and health professionals when needed to ensure people received safe and effective support.

The registered manager told us there was a culture of continuous improvement at the care service and part of this was through learning and best practices. The registered manager also told us feedback was continuously sought from people, relatives and staff to learn about any potential shortfalls through feedback, supervisions and meetings. Any actions arising from feedback were put onto an action plan and used to make improvements. We saw an action plan was in place. However, action was required to ensure learning from incidents was completed in full and systems in place to ensure this was communicated to all staff as some staff told us that learning was not always communicated to them.

Robust systems were not in place for learning and improvement. Records showed that some learning had taken place in some areas. However, robust audit arrangements were not in place to ensure shortfalls were identified and improvements and learning were sustained. We also found learning was not consistently taking place following incidents to ensure people received safe care.