Prestige Nursing Bracknell was rated Requires Improvement overall due to a breach of Regulation 17 (Good governance), with no evidence of audits since March 2021. Safe, effective, caring and responsive were all rated Good, with positive feedback on staff and person-centred care, though concerns were raised about late visits, staffing levels and training frequency.
Concerns (8)
critical
Governance
: “The provider had not operated an effective system to enable them to assess, monitor and improve the quality and safety of the service provided.”
criticalGovernance: “During the inspection, there was no evidence audits had been completed since March 2021.”
moderateMissed or late visits: “People told us staff were sometimes late to visits, "sometimes they can turn up rather late"”
moderateStaffing levels: “Due to staff shortages, some staff told us that there was not always enough time between visits.”
minorStaff training: “safeguarding for adults and children was completed by all staff it was refreshed every two years. Best practice recommends safeguarding training should be refreshed annually.”
minorMedication management: “Where people were prescribed 'as required' (PRN) medicines, there was not always an individualised protocol which explained to staff why the medicine would be given”
minorConsent / capacity: “The service was not completing the capacity document within the care plan although people's capacity was documented elsewhere.”
minorRecord keeping: “One staff file did not include evidence of conduct at a previous role within health and social care.”
Strengths
· Open and transparent way of working ensuring safety of people using the service
· Staff knew people they supported well and cared about their wellbeing
· Medicines were stored and given to people safely
· Risk assessments clearly written with clear instructions for staff
· Effective infection prevention and control measures in place
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Assessing risk, safety monitoring and managementNot rated
safe: Staffing and recruitmentNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies to provide consistent, effective, timely careNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsNot rated
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated
well-led: How the provider understands and acts on the duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staff; Continuous learning and improving careNot rated
well-led: Working in partnership with othersNot rated