The inspection took place on 6 November 2018. The inspection was announced. This service is a domiciliary care agency. It provides personal care to any adults who require care and support in their own houses and flats in the community. Not everyone using Prestige Healthcare Services receives a regulated activity. The Care Quality Commission only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do receive personal care we also take into account any wider social care provided.

At the time of inspection, the service supported 22 people who were receiving personal care in their own homes. The service provides support to older people, people with physical disabilities, sensory impairment and people living with dementia.

This is the first inspection since the service was registered.

At this inspection we have found the service was not always safe and well-led. Therefore, the service has been rated as Requires Improvement in these domains. The service has been rated Good in effective, caring and responsive. As a result, the service was rated overall as Requires Improvement.

People’s medication records did not always reflect that they were administered safely. It was not always clear that people received their medications as prescribed. Risk assessments did not always provide sufficient information to provide direction for staff, or information about how to reduce risks. This was a breach of Regulation 12 the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The registered manager conducted some quality assurance audits to monitor the running of the service. However, we found that these were not always effective and didn’t always identify gaps in medication records. Quality assurance records did not always reflect the provider had monitored, assessed and improved the quality of the service being delivered. This was a breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014.

The provider had not always notified CQC of other incidents. This meant we could not check that appropriate action had been taken to ensure people were safe. The provider is in breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

People told us they felt safe. There were some systems in place to protect people from the risk of abuse and potential harm. Staff were aware of their responsibility to report any concerns they had about people's safety and welfare.

Staff received an induction and ongoing training, to help them meet and understand the care needs of the people they supported. Staff said they felt supported in their roles.

Staff were aware of their responsibilities to ensure people's rights were promoted. Where required, people were supported to access healthcare services to maintain their health and wellbeing.

People's dignity and privacy was respected. People told us staff were reliable, friendly, and caring. Staff developed positive and caring relationships with the people.

People's nutritional needs were catered for and the level of support provided was dependant on people's abilities.

Staffing levels were monitored by the registered manager to ensure sufficient staff to meet the needs of people and to keep them safe from harm. Recruitment procedures to appoint new staff were in place.

The provider had continuity plans in place to ensure that people's support needs would still be met in emergency situations. Infection control policies and procedures were followed to ensure the control of infection.

You can see what action we told the provider to take at the back of the full version of the report.