Prestige Nursing Plymouth is a service that provides both nursing and care staff to people in the independent, hospital and community sectors. This inspection only covered the regulated activity provided to people in their own homes by care staff. The service provides care and support to people of all ages, in their own homes. Prestige Nursing Plymouth provides support with people’s social, domestic and personal care needs in Plymouth and the surrounding area.

The service mainly provides care and support for people in visits at key times of the day to help people get up in the morning, go to bed at night and give support with meals. Prestige Nursing Plymouth also provides social support to enable people to access the community and their interests. This includes supporting people with physical disabilities, learning disabilities and dementia care needs. The service only provides care visits of one hour or longer. Many visits are for a few hours each day. The service also provided effective flexible urgent care which was often arranged at short notice to cover a person’s usual carer’s absence, for example when they were unwell.

At the time of our inspection 30 people were receiving a service. These services were funded either privately, through Plymouth City Council or NHS funding.

We carried out this announced inspection on 17 January 2019. We told the provider one day before that we would be coming. This in in line with our methodology for inspecting domiciliary care providers and ensures that someone will be present in the office when we visit.

The service was last inspected on the 2 September 2016. Prestige was found to be meeting the regulations and was rated overall Good at that time.

There was a registered manager in post. 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.

Everyone we spoke with, without exception, told us that the service provided by staff and management at Prestige Nursing Plymouth was outstanding. External healthcare professionals told us, “They go out of their way to facilitate what is needed for the person,” and “They were always my first choice if we needed agency cover as they always sent well trained, hardworking, thoughtful staff.”

Staff were extremely well supported by the registered manager. We noted many appreciative emails sent out to care staff by the registered manager thanking them for their valued work. Staff were very happy working for the service and told us, “Prestige is the best company I have ever worked for. [The registered manager] is always there for us 100%. I would recommend Prestige to anyone to work for,” “The one thing I love about working for Prestige is that you don’t limit me to what I can do, you have full support for me to achieve more. You’ve never doubted me for a minute, or what I am capable of and that means a lot”

The service had very happy and motivated staff who were regularly recognised for their long service, hard work and specific achievements. Care staff felt valued. They went above and beyond their day to day support and care tasks, often checking on the more vulnerable people they supported as they travelled around the local area, even when off duty. If they saw something that was not as expected, such as lights off or curtains closed inappropriately, they would take action to ensure the person was safe and well. This had often led to a person being found requiring assistance which would not have been provided had the caring Prestige staff not noticed something may be amiss.

Staff were clear about how to report any safeguarding concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. There were suffic

Prestige Nursing-Plymouth is a domiciliary care service that provides care and support to adults of all ages in their own homes. The service provides help with people’s personal care needs in Plymouth and surrounding areas. The service supports some people who may require help with personal care needs at specific times of the day and/or night. At the time of the inspection 30 people were receiving support with personal care needs.

A registered manager was employed to manage the service locally. 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 they felt safe using the service. There were risk assessments in place to help reduce any risks related to people’s care and support needs. Staff had received training in how to recognise and report abuse and were confident any allegations would be taken seriously and investigated to help ensure people were protected.

There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service. The recruitment process of new staff was robust. People and staff were matched carefully and people could meet staff before they started receiving care from them.

People received support from staff who knew them well and had the knowledge and skills to meet their needs. People and their relatives spoke highly of the staff and the support provided. Comments included, “They’re brilliant. They’re the best ones we’ve had.”

The registered manager and staff had attended training on the Mental Capacity Act 2005 (MCA). No-one supported by the service currently lacked mental capacity but staff had received training and were clear what actions to take if they suspected someone was no longer able to make decisions for themselves.

There was a positive culture within the service. The registered manager had clear values about how they wished the service to be provided and these values were shared by the whole staff team. Staff talked about ‘personalised care’ and ‘respecting people’s choices’ and had a clear aim about improving people’s lives and opportunities.

There was a management structure in the service which provided clear lines of responsibility and accountability. A registered manager was in post who had overall responsibility for the service. They were supported by other senior staff who had designated management responsibilities. People told us they knew who to speak to in the office and any changes or concerns were dealt with swiftly and efficiently.

Feedback received by the service and outcomes from audits were used to aid learning and drive improvement across the service. The manager and staff monitored the quality of the service regularly by undertaking a range of regular audits and speaking with people to ensure they were happy with the service they received. People and their relatives told us the management team were approachable and included them in discussions about their care and the running of the service. Comments included, “They’re very approachable and will go out of their way to help.”