Manchester Primecare, a small domiciliary care agency supporting 5 people, improved from Requires Improvement to Good across all five key questions at its February 2023 inspection. Previous breaches of Regulations 12 and 17 were resolved, with robust risk management, medicines safety, staff training, person-centred care planning, and governance systems now firmly embedded.
Strengths
· Risks were robustly assessed and mitigated, with staff aware of strategies; previous breach of Regulation 12 resolved.
· Medicines were safely managed with competency checks completed by the registered manager.
· Staff received Care Certificate-linked induction, annual training, regular supervision and spot checks.
· Care plans were detailed, person-centred, regularly reviewed, and incorporated individual preferences and communication needs.
· Robust complaints management process in place; no complaints since last inspection.
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversity; privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Continuous learning and improving care; Managers and staff being clear about their roles and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood
Manchester Prime Care remains rated Requires Improvement following a focused inspection, with continued breaches of Regulation 12 (safe care and treatment) due to inadequate risk assessment and Regulation 17 (good governance) due to insufficient provider oversight. Improvements in recruitment, training and staff support were noted, and the service exited Special Measures, but further embedding of changes is needed under the new manager.
Concerns (8)
criticalCare planning: “Risks to people had not always been identified. Clear guidance was also not always in place to manage risks that had been identified”
criticalCare planning: “there was no environmental risk assessment for one person's home and one person was at risk of taking too much medication after drinking alcohol but no measures to manage this risk”
criticalIncident learning: “one person had fallen asleep whilst smoking but no risk assessment was in place to identify measures to reduce the risk of a fire.”
criticalGovernance: “further work was needed to ensure robust quality assurance systems were fully implemented by the manager and the provider had sufficient oversight of the service”
moderateIncident learning: “under the previous manager, actions had not always been taken following an incident to reduce the risk of the same thing reoccurring”
moderateLeadership: “there had been a further change of ownership, management arrangements and the nominated individual had left. This showed the leadership at the service continued to be inconsistent.”
moderateSafeguarding: “We were aware of a safeguarding that was currently being investigated relating to charges for the support provided by Manchester Prime Care under the previous registered manager.”
minorRecord keeping: “the recording of financial transactions could be improved further”
Strengths
· Staff had received the training required to meet the needs of the people currently supported, including alcohol awareness and medicines administration.
· Staff files for current employees had been reviewed and all pre-employment checks were now in place; new recruitment pack introduced.
· People and professionals were very complimentary about the staff and the support provided.
· Staff were provided with sufficient PPE and had received training in its use, including donning and doffing.
· Support each person needed to take their medicines was clearly recorded in care plans; staff completed on-line medicines training and assessments.
Quality-Statement breakdown (9)
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongRequires improvement
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
well-led: Continuous learning and improving care; Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringNot rated