1st Homecare Solutions Limited is registered with the Care Quality Commission as a Domiciliary Care Agency to provide personal care to people in their own homes. At the time of our inspection there were approximately 81 people using the service.

At the last inspection, the service was rated as ‘requires improvement’ because there was inadequate travel time allowed between visits and the providers quality assurance systems had not been used effectively to identify and resolve this.

At this inspection we found the service was Good.

The service had a Registered Manager in place but not all people knew who the registered manager was. 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 service took safeguarding concerns seriously and followed the local authority policy and guidance when dealing with safeguarding people from harm.

Where appropriate the service had attended and contributed to safeguarding discussions and meetings.

There was a robust recruitment procedure to help ensure the staff recruited were suitable to work with the people using the service.

Staffing levels were sufficient to provide the level of care required.

Risk assessments were in place and were regularly reviewed and updated.

Staff were trained to administer medicines safely. Regular checks were undertaken to help ensure on-going competency in this area.

There was a robust induction programme, which included mandatory training, shadowing and buddying with an experienced worker. Staff demonstrated a good understanding of their roles and responsibilities.

Supervisions were undertaken and Professional Development Reviews (PDR) was held annually to ensure learning was reviewed and training needs were met.

Care files were clear and comprehensive and contained relevant health and personal information. The service was flexible and responsive to changing needs, desires and circumstances.

Confidentiality was respected and independence was promoted. Communication with relatives was on-going throughout the duration of their relative’s involvement in the service.

Comments were encouraged formally and informally and there was a complaints policy in place. Literature given out to families gave the information and opportunity for people to raise concerns or make suggestions.

Feedback was regularly sought from families and users of the service. The service listened and took action to address any concerns and suggestions put forward by people who used the service and their families.

Team meetings were regularly undertaken, giving staff the opportunity to discuss any issues and to share good practice examples. The meetings were used as a forum to share current best practice guidance and keep staff up to date with new methods and innovation.

A number of audits were undertaken, results analysed and lessons learned from these to drive continual improvement in service delivery.

We carried out an announced inspection of this service on 30 August 2016, when we visited the provider’s offices and spoke with people who used the service, and their relatives. We also spoke with members of the staff team on this date and by telephone on 8 September 2016. We last inspected this service in August 2015 and found that the service was not always safe, effective and well-led. Therefore, we awarded them an overall rating of ‘requires improvement.’

1ST Homecare Solution is a domiciliary care agency providing personal care and support for people in their own homes. There were eighty-eight people using the service at the time of our inspection.

The service had a registered manager who was also the provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 provider’s quality assurance systems were not always effective in identifying areas of improvement. People did not always know who the registered manager was but they found the office staff to be helpful and approachable. The people who used the service and their relatives were able to contribute to the development of the service by way of satisfaction surveys. Staff were also involved in the development of the service by way of weekly team meetings.

Staff were trained in safeguarding people and they knew how to keep people safe. There were enough staff to provide care to people who used the service, and people had individualised risk assessments in place to manage risks they were exposed to. However, the travel time allocated to staff from one care visit to the next was not always adequate causing rushed or late care delivery.

Some people raised concerns about the support they received in relation to their medicines management, and we found a lack of evidence to show that one member of staff had the right to work in the United Kingdom which the provider was required to ascertain before allowing potential staff to take up employment, in line with their recruitment policy and the law.

There were mixed feedback about the quality of training offered to staff but people and their relatives agreed staff were knowledgeable about people’s care needs. Staff understood their responsibility to sought people’s consent before providing any care in line with the requirements of the Mental Capacity Act 2005. They were supported in their roles by way of regular supervision and appraisals of their performance.

We received mostly positive feedback from people who used the service and their relatives about staff. We found staff to be knowledgeable about the people they cared for and they were respectful of people’s privacy and dignity. They respected people’s views and provided care that was personalised to people.

This inspection took place on 6 August 2015 and it was announced.

1st Homecare Solution is a domiciliary care agency providing personal care and support for people in their own homes. At the time of our inspection the agency was providing a service to 60 people.

The agency has a registered manager, who is also the provider. 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.

There were systems in place to safeguard people from the risk of possible harm. There were risk assessments in place that gave guidance to staff on how risks to people could be minimised.

Some staff lacked an understanding of safeguarding processes and some training was out of date. Spot check, supervisions and appraisals were not consistently completed for all staff.

People’s needs had been assessed, and care plans took account of their individual needs, preferences, and choices.

The provider had effective recruitment processes in place and there were sufficient staff to support people safely. Staff understood their roles and responsibilities to seek people’s consent prior to care being provided.

People were supported by caring and respectful staff.

The provider had a formal process for handling complaints and concerns. These were recorded, investigated and responded to, but actions to prevent recurrence were not always recorded.

The provider encouraged feedback on the service provided. However, an action plan had not been developed to address the issues raised with a view to continuously seeking to improve the service.

The provider had quality monitoring processes in place.