We inspected the service on 6 November 2018. We gave the service 48 hours’ notice of the inspection visit because it is a domiciliary care service and the manager is often out of the office supporting people or staff.

Prestige Nursing Leicester is a domiciliary care service providing care and support to people living in their own homes. The office is based in Ashby de la Zouch Leicestershire. The service provides support to people living in Leicestershire and surrounding towns and villages. They support people with a variety of care needs including physical disabilities, learning disabilities, palliative care and general care. At the time of our inspection there were 77 people using the service.

At our last inspection on 28 January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good but there had been a deterioration in ‘safe’ which was rated as ‘requires improvement’. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had deteriorated to requires improvement for ‘safe’ because people told us their care calls were often late. The registered manager had already identified and begun to resolve this issue. People were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs including the environment, had been assessed and planned for and these were monitored for any changes. People did not have any undue restrictions placed upon them. There were sufficient staff to meet people’s needs and safe staff recruitment procedures were in place and used. People received their prescribed medicines safely and these were managed in line with best practice guidance. Lessons were learned when things went wrong and learning was used to continually improve.

People continued to receive an effective service. Staff received the training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs. Staff were able to identify when people were unwell and took appropriate action. The staff worked well with external health care professionals, people were supported with their needs and accessed health services when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People continued to receive care from staff who were kind, compassionate and treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. Staff knew how to comfort people when they were distressed and made sure that emotional support was provided. People’s independence was promoted.

People continued to receive a responsive service. People’s needs were assessed and planned for with the involvement of the person and or their relative where required. Staff knew and understood people’s needs well. People received opportunities to follow their interests and hobbies. There was a complaints procedure and action had been taken to resolve the complaint and to learn and improve where this was possible.

The service continued to be well led. People and staff felt supported by their managers. There were effective systems in place to monitor the quality of the service. There was an open and transparent and person-centred culture and good leadership. People were asked to share their feedback about the service and action was taken in response.

Further information is in the detailed findings below

We carried out our inspection on 28 January 2016. The inspection was announced.

Prestige Nursing Leicester is a domiciliary care service providing care and support to people living in their own homes. The office is based in Ashby de la Zouch Leicestershire. The service provides support to people living in Leicestershire and surrounding towns and villages. They support people with a variety of care needs including physical disabilities, learning disabilities, palliative care and general care and domestic needs. At the time of our inspection there were 74 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that they felt safe using the services of Prestige Nursing Leicester. They felt safe because they trusted staff’s ability to look after them. Staff knew their responsibility to keep people safe from harm and abuse. They followed the provider’s guidelines to support people and report any concerns they had on people’s safety and wellbeing.

Staff had the relevant skills they required to meet people’s needs. The provider completed relevant checks which ensured that staff had the right skills, experience and were safe to support people. Staff were provided with adequate training that they required to carry out their role effectively.

People were supported in accordance with the Mental Capacity Act (MCA) 2005.

Staff supported people to meet their nutritional needs. They also supported people to access health care services when they needed this.

People told us that staff were kind and compassionate to them. Staff were knowledgeable about the needs of the people they supported. They also treated people with dignity and respect.

People’s care plans reflected their individual needs and preferences. Their care was provided in a person centred manner. The provider listened to feedback from people using the service and their relatives. People told us that staff acted promptly on their feedback.

People told us that they were satisfied with the service they received. Staff felt supported to contribute to the development of the service. They felt supported in their role which enabled them to deliver a good standard of care. The provider had effective procedures for monitoring and assessing the quality of service that people received.