This inspection took place on 20 September 2016 and was announced. We also made phone calls to staff, people and their relatives on 26, 27, 28, 29 and 30 September 2016.

We last inspected this service in September 2015. At that inspection we found the provider was not meeting all the regulations. We found suitable arrangements were not in place to support staff through the provision of training, supervision and appraisal, consent to care and treatment had not been obtained from people, recruitment checks were not robust enough and systems in place to monitor and improve the quality of the service were not effective. An action plan was received from the provider which stated they would meet the legal requirements by 20 January 2016. At this inspection we found improvements had been made and the provider was no longer in breach of the regulations.

18 Portland Terrace is registered to provide personal care to people in their own homes. 18 Portland Terrace has two key parts; Care and Share Associates (CASA) and LIFE. CASA provides care at home services for people in Newcastle including palliative and end of life care. LIFE is an Independent Supported Living (ISL) service for people with learning disabilities, which operates across Newcastle and North Tyneside. At the time of this inspection, 18 Portland Terrace was providing care to approximately 300 people. Of these people, approximately 50 people were being supported by LIFE.

The service had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were kept safe from harm. Staff completed safeguarding training as part of their induction and this was refreshed on an annual basis. Staff were aware of the different types of abuse people might experience and of their responsibility for recognising and reporting signs of abuse. People told us they felt safe.

Possible risks to the health and safety of people using the service and the staff members who supported them were assessed. Where risks were identified, care plans were created to provide advice and guidance to staff members on how to safely support the person whilst also taking into account the person’s wishes and rights.

We found improvements had been made to the systems for the recruitment of new staff members. Checks were completed to establish whether potential staff members had criminal records, to determine their right to work in the UK and references were sought to verify the information supplied on their application forms. Recruitment files were reviewed by senior staff members to ensure potential staff members were suitable before they were allowed to work with people.

People were assisted to take their medicines safely by staff who had been appropriately trained. Medication Administration Records (MARs) were returned to the office on a regular basis and checked by senior staff members to ensure people were receiving their medicines as prescribed.

Staff were given the appropriate training and support they required to work effectively. Staff spoke highly of the training they received and the provider encouraged and supported staff to undertake additional qualifications relevant to their roles.

People’s rights were respected and protected. Care staff were aware of the importance of offering people choice and respecting their wishes. Information was provided in people’s care records of any assistance people required to make informed choices about their care. The service was in the process of introducing new documentation which provided addition direction to staff where there were concerns about a person’s capacity to make decisions about their care and treatment.

Care workers were described as kind an

We carried out an announced comprehensive inspection of this service in December 2014. After that inspection we received concerns in relation to possible breaches of the regulations regarding staffing and safeguarding people from abuse. As a result we undertook a focussed inspection to look into those concerns. This report only covers our findings with regard to these regulations. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ section for 18 Portland Terrace on our website at www.cqc.org.uk

This inspection took place on 8 September 2015 and was unannounced. We also conducted interviews with staff by phone on 14 and 17 September 2015.

We last inspected this service in December 2014. At that inspection we found the service was meeting all the legal requirements in force at that time.

18 Portland Terrace is registered to provide personal care to people in their own homes. 18 Portland Terrace has two key parts, Care and Share Associates (CASA) and LIFE. CASA provide care at home services for people in Newcastle. LIFE is an Independent Supported Living (ISL) service for people with learning disabilities, which operates across Newcastle and North Tyneside.

It does not provide nursing care.

The service had two registered managers, one of whom had recently resigned. 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.

The specific concerns were that staff were being required to work excessively long shifts, to the potential detriment of those people they were supporting; that staff training was not up to date; and that safeguarding issues were not responded to appropriately.

We found no evidence that safeguarding issues were not taken seriously or dealt with appropriately. Safeguarding records showed the service had reported all allegations of abuse or potential abuse to the local authority safeguarding adults unit, and notified the Care Quality Commission of the same, as required.

We found that, although some staff were working hours well in excess of 48 hours per week, they confirmed to us this was done on a voluntary basis, and that there was no coercion involved. Care workers told us they did not believe their ability to carry out their roles was affected by the long hours sometimes worked. We found no evidence that the care or safety of people receiving a service had been compromised.

However, we found the service had not ensured that staff working in excess of 48 hours per week had signed a ‘working time directive opt-out’ form. This is a form that allows staff to ‘opt out’ of the European Union restrictions on working excessive hours. We further found some staff had not been issued with contracts or statements of terms and conditions of employment. This meant staff members’ legal rights were not always being protected.

We found the systems in use for employing new staff were not always effective in ensuring that only suitable applicants were employed.

Staff had not been given all the training they required to meet the needs of the people they provided a service to. Nor had staff received the support they required to carry out their roles, in that they were not given regular supervision and appraisal of their work.

We found the systems for auditing the quality of the service being provided were insufficiently rigorous and had not identified shortfalls in the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of staffing, consent, employment and good governance. You can see what action we told the provider to take at the back of the full version of the report.

We undertook an announced inspection of Newcastle Home Care Associates Limited on 2, 5, 8, 9 and 15 December 2014. The service is registered with CQC and operates under the title 18 Portland Terrace. We last inspected 18 Portland Terrace in June 2014.

At the last inspection we found the provider was not meeting all the regulations inspected. We found suitable appraisal and supervision arrangements for staff were not fully in place. We also found people were not always protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained. An action plan was received from the provider which stated they would meet the legal requirements by 31 October 2014. At this inspection we found improvements had been made and the provider was no longer in breach of the regulations.

18 Portland Terrace is registered to provide personal care to people in their own homes. 18 Portland Terrace has two key parts, Care and Share Associates (CASA) and LIFE. CASA provide care at home services for people in Newcastle. LIFE is an Independent Supported Living (ISL) service for people with learning disabilities, which operates across Newcastle and North Tyneside. At the time of the inspection CASA was supporting 288 people and LIFE was supporting 47 people.

The service had two registered managers; one who managed CASA and one who managed LIFE. Both managers had been in post since 2010. 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 using the service and their relatives told us they were well cared for and felt safe with the staff who provided their support. One person told us, “I feel safe with my staff. A lot of them know me really well now; they are friendly and nice.” Staff we spoke to understood what abuse was and knew how to report abuse if required.

We found that staff were recruited appropriately and they had the skills and knowledge to safely care for people. Risks were assessed and managed well, with care plans and risk assessments providing clear information and guidance to staff.

People were assisted with their medicines in the right way. The provider had a detailed policy in relation to medicines management, so staff had access to information and were clear about what was good practice. Staff competency regarding medication handling was subject to regular supervisory observation checks and medicine training was refreshed annually.

The service followed the requirements of the Mental Capacity Act 2005 (MCA). MCA assessments and ‘best interests’ decisions had been undertaken by the relevant supervisory body where there were doubts about a person’s capacity to make decisions.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs. People were also supported to eat and drink.

Staff knew the people they were supporting and provided a personalised service. Care support plans were in place detailing how people wished to be supported. Risk assessments were also in place to effectively manage risks. People told us they generally saw the same core group of care staff. They told us they liked the staff who provided their care and support and enjoyed their company. One person told us, “My carers are marvellous.” Other people’s comments included, “I’ve got one main carer,” “There are odd occasions where I get a new member of staff; but it doesn’t happen very often,” and, “It’s always the same care staff who come and visit me,” Relatives comments included, “Yes, she gets the same two girls,” and, “She’s never been happier.”

The service was flexible and responded positively to people’s requests. People who used the service and their relatives told us they were able to raise issues and concerns and the service was responsive to their requests. People were supported by staff to access their communities, pursue leisure interests and educational opportunities. One person told us, “They [staff] always ask me what I want doing.” Another person said, “She (staff member) does everything she’s supposed to and she does anything that I ask her to do and more.”

Systems were in place to monitor the safety and quality of the service and to gather the views of people, including whether they were happy with the quality of the services provided. The provider supported care workers and managers through effective inductions, training and supervision and with regular meetings to share best practices. Care and support was provided by a consistent team of care staff who knew people well. Staff had the necessary knowledge, skills and experience to meet the needs of the people they supported.