Prestige Nursing York is a domiciliary care service registered to provide personal care to people living in their own homes.

We inspected this service on 7 and 19 April 2017. The registered provider was given 48 hours’ notice of our inspection, because the location provides a domiciliary care service and we needed to be sure that someone would be in the location’s office when we visited. At the time of our inspection there were nine people using the service. At the last inspection, the service was rated ‘Good’. At this inspection, we found the service remained ‘Good’.

People who used the service felt safe with the care and support that staff provided. People were protected from the risk of abuse by staff trained to identify and respond to safeguarding concerns.

Robust recruitment procedures were in place and sufficient staff were employed to ensure people’s needs were met. We received positive feedback about the consistency of staff that supported people who used the service. This enabled people to develop positive caring relationships with the staff that visited them and supported staff to get to know people and how best to meet their needs.

Care plans and risk assessments were used to provide guidance to staff on how to safely meet people’s needs. Care plans and risk assessments were person-centred.

Staff received comprehensive training and on-going supervisions, spot checks and appraisals were completed to support continued professional development. Systems were in place to support staff to safely administer medicines. Staff supported people to ensure they ate and drank enough.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. We spoke with the registered manager about maintaining clearer more robust records where there were concerns regarding people’s mental capacity.

People who used the service provided very positive feedback about the kind, caring and attentive staff that supported them. Staff supported people to have choice and control over their care and support and to maintain their privacy and dignity.

People who used the service, relatives and staff we spoke with told us the service was well-led. There was a positive atmosphere within the service. The service was well organised and there was a comprehensive system of audits to monitor the quality of the care and support provided. Although there had been no complaints about the service, there was a system in place to gather and respond to feedback about the service provided.

Further information is in the detailed findings below.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. 

The inspection was announced.  During the visit we went to the main office in York and then spent time talking to thirteen people and/or their relatives by telephone to gain their views of the service. We spoke with three staff during our visit and 1 staff member afterwards by telephone.

Prestige Nurse Agency provides support to people of varying ages, both in their own homes and in the community.  This includes support with shopping, personal care, eating and drinking. On the day of the inspection twenty people were using the service.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People told us they felt safe being supported by staff employed by Prestige Nurse Agency.

Staff were trained in safeguarding vulnerable adults and discussions with staff confirmed they were clear about what to do should an allegation be made. Recruitment records viewed contained the required information. This helped to protect people who were supported by this agency.

People said they knew how to complain and we saw the complaints procedure was included in the service users guide to support people in doing so.

The agency had policies, procedures and systems in place which supported staff to deliver care effectively. People told us they were able to make choices and decisions and were involved in discussions regarding their care records.

Staff received training and supervision to support them in their roles. Staff confirmed the training they received supported them in caring for people appropriately.

All of the people we spoke with told us they were well cared for. They were positive about the staff who supported them. They confirmed that they were treated with privacy and dignity by the staff who supported them.

We found that people’s health needs were responded to. Appropriate guidance and support was accessed where required.

People told us they could express their views and opinions and felt listened to by management. Relatives also confirmed this. There were good quality monitoring systems in place to review and develop the service.

People we spoke with told us that they were happy with the care and support they received. One person we spoke with said “The carers do all the necessary things I need. They listen to my needs”. Another person said “This is a super agency, very good and reliable. The care staff are reliable, pleasant caring and very good. I am grateful for this.” People we spoke with confirmed their care needs were met.

People were protected from the risk of infection because staff had received training and guidance which helped to protect all parties. And appropriate procedures were followed.

There were enough skilled and experienced staff to meet people’s needs. This was confirmed by people we spoke with who said that the staff were skilled and professional. One person said “It is the same few carers who look after me. They are skilled.”

The quality of the service being provided was monitored by the manager. There were effective complaints policies and procedures in place. Any issues found were acted upon to ensure people remained satisfied with the service they received.

We spoke with people who use the service by telephone and with the staff and the management team both by telephone and during our visit.

People who use the service told us that they were happy and satisfied with the care and support being provided. Comments made to us during this review included, “This agency is the best by far we have had.” “The staff are very capable.” “I cannot fault anything they do.” People also told us that staff supported them as they wished to be supported and were always professional.

When we spoke with staff they told us they were well trained and felt confident to do their work. They said that they were well supported by their management team and were provided with up to date information that they needed to do their jobs effectively.