Prestige Nursing Sleaford is registered to provide nursing and personal care for people of all ages who live at home. The service is also registered as a nurses’/care staff agency. As such it can provide nurses and care staff to work in residential settings that are run by other registered persons. In our report we refer to these parts of the service as being the ‘domiciliary care service’ and the ‘nurses’/care staff agency’ respectively. When reporting our findings we generally refer to care staff working in both parts of the service unless otherwise stated.

At the time of our inspection visit, both parts of the service only provided personal care. The domiciliary care service provided assistance for 63 people who lived in Sleaford, Ruskington, Heckington and Helpringham. The nurses’/care staff agency provided a small number of care staff who worked in five residential care settings all of which were located in south Lincolnshire. These members of staff were provided on a shift by shift basis as and when requested.

As part of its domiciliary care provision, the service also delivered palliative care. This part of the service covered the whole of the county. It involved care staff providing intensive personal care for people who were receiving care at home and who were nearing their end of their lives.

The service's office was in Sleaford.

Prestige Nursing Sleaford is operated by a company. There was 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. In this report when we speak about both the company and the registered manager, we refer to them as being, 'the registered persons'.

At the last inspection on 13 August 2015 the service was rated ‘Good’.

At this inspection we found the service remained ‘Good’.

Care staff knew how to keep people safe from the risk of abuse including financial mistreatment. People had been helped to avoid preventable accidents and medicines were safely managed. There were enough care staff in the domiciliary care service and planned visits had been reliably completed. Background checks had been completed before new care staff had been appointed.

Care staff had received training and guidance and they knew how to care for people in the right way. In the domiciliary care service people were supported to prepare meals and care staff made sure that they had enough to eat and drink. In addition, people had been helped to obtain all of the healthcare assistance they needed.

In the domiciliary care service people were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

People who used the domiciliary care service people told us that they were treated with compassion and respect. Care staff recognised people’s right to privacy and promoted their dignity. When necessary, people had been supported to access independent lay advocates and confidential information was kept private.

Care staff in the domiciliary care service had involved people and their relatives in making decisions about the care that was provided. People had been given all of the assistance they had agreed to receive. Care staff promoted people’s ability to pursue their hobbies and interests. There were arrangements for quickly and fairly resolving complaints.

People who used the domiciliary care service had been consulted about the development of the service and quality checks had been completed. There was an established staff team and good team work was promoted. Care staff had been supported to speak out if they had any concerns about people not receiving safe care.

Further i

This was an announced inspection carried out on 13 August 2015.

Prestige Nursing Sleaford provides care for people in their own homes. At the time of our inspection the service was providing care for 55 people most of whom were older people. The service covered Sleaford and surrounding villages. In addition to this provision, the service was an employment agency that provided care staff to work in care homes which were operated by other organisations.

There was manager who was applying to be registered with the Care Quality Commission. A registered manager is a person who has registered with us 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.

There were separate teams of staff. We refer to the staff who provided care to people in their own homes as being ‘domiciliary care workers’. The staff who were contracted to work in other organisations’ services are referred to being ‘agency staff’. When we refer to the staff working in both teams we refer to them as being ‘staff’.

Staff knew how to recognise and report any concerns so that people were kept safe from harm and abuse. People had been helped to avoid having accidents and medicines were managed safely. There were enough staff and background checks had been completed before new appointments had been made.

Staff had received the training and guidance they needed to provide people with the care they needed including helping them to eat and drink enough. People had been helped to receive all of the healthcare assistance they needed. Staff had ensured that people’s rights were protected. This was because the Mental Capacity Act 2005 Code of Practice was followed when staff contributed to decisions that were made on their behalf.

People who received assistance at home were treated with kindness, compassion and respect. Staff recognised people’s right to privacy, respected confidential information and promoted people’s dignity.

People who received assistance at home had received all of the care they needed including people who had special communication needs and were at risk of becoming distressed. People had been consulted about the care they wanted to receive and they were supported to celebrate their diversity. Staff had offered people the opportunity to maintain their independence and to pursue their interests.

The registered person and manager had completed regular quality checks. The service was run in an open and inclusive way that encouraged staff to contribute to its development. People who received assistance at home had been consulted about the service’s development. In addition, people at home and those using other organisations’ services had benefited from staff being involved in good practice initiatives.

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with two people who used the service and a relative and asked them for their views. We also spoke with three care workers, a registered nurse, the care coordinator, the schedule coordinator and the manager. We contacted staff from two residential homes who the provider supplied staff to work at. We looked at some of the records held in the service including the care files for three people.

We found where people were able to they gave consent to their care and treatment. A person told us they were in agreement with their care plan. They said, “Yes I am (in agreement). I remember signing them.””

We found people received care and support that met their needs. A person told us, “I feel my care plan describes what I need. Every so often someone comes and goes over it with me to make sure everything is covered.”

We found people were safeguarded from abuse. A relative told us they thought their relation was “very safe” when they received support from the care workers.

We found staff team were supported through training. A person told us, “I think they have been properly trained.”

We found the provider assessed and monitored the quality of the service. A person told us, “They asked if I was satisfied. I said yes.”

We found people who used the service were involved in decision making about the care and support they received. People we spoke with said that staff listened to their views and respected their opinions about how they wanted to receive their care. One person we spoke with said, “They (carers) are very accommodating, flexible and helpful as I need them”.

We found that there were sufficient numbers of suitably skilled and trained staff to delivery care safely.

People said that the agency was providing a reliable, flexible service that was meeting their needs. They said their views about how they wished their support to be delivered had been listened to and respected.

People told us that they felt confident taking any concerns and suggestions to the manager or any of the staff team. One person said, “Anything I ring about is dealt with immediately.” Another person said, “When I contact the office they are always polite and ready to sort out any concerns I have”.

The manager told us that they regularly sought feedback from people, their representatives and other health care professionals using the service and their feedback was used to assess and monitor the quality of the service provided. One person told us that they gave feedback on each carer that attends and they give most ten out of ten. Another person who used the service said, “It gives us an opportunity to let the staff know we rate them highly for the work they do”.