About the service: Absolute Quality Care provides personal care to people with a range of health issues in their own homes. At the time of the inspection 77 people were provided with care and support.

People’s experience of using this service: Staff continued to be good at caring for people and demonstrated a visible person-centred culture. People and their relatives were complimentary about the care provided by staff and said they were kind and compassionate.

Privacy was maintained, and people were treated with dignity and respect. There was evidence to show people’s independence was maintained. Wishes, preferences and what was important to people were recorded and followed by staff when care was delivered.

There were enough staff to support people and the provider tried to ensure continuity was maintained whenever possible. Safe recruitment procedures continued. Induction and training was provided to ensure staff had appropriate skills. A small number of staff said they sometimes felt undervalued; the provider was looking into this. Although processes were in place for staff to receive support, this had not always occurred formally. We have made a recommendation and will follow this up.

People said they were safe with care staff visiting them and knew how to raise a complaint if needed. Staff could explain how to report any concerns they had. Risks to people had been assessed and staff had a good understanding of these risks and how to minimise them.

Medicines were generally managed well. Issues we found were addressed immediately. The provider was in the process of implementing new procedures and this needed to be embedded.

People’s nutritional needs were met, and people were happy with the support they received to enjoy a choice of meals and maintain a healthy diet. Partnership working with other healthcare professionals was proactive and positive.

People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible.

People and relatives spoke positively about the provider, staff and the service provided. The provider monitored the quality and safety of the service through regular checks and audits and these were in the process of being reviewed.

The provider remained rated as good overall as they provided good quality care to the people they supported.

For more details, please see the full report below and which is also on the CQC website at www.cqc.org.uk.

Rating at last inspection: Good (Report published on 6 October 2016).

Why we inspected: The inspection was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This was an announced inspection which took place over three days; 8, 21 and 30 June 2016. This is the services first inspection since Re-registering with the Care Quality Commission in May 2016.

Absolute Quality Care is a domiciliary care service that is registered for the regulated activity of personal care. The service provides care and support to people in their own homes in the Tyneside area. The care offered varied from short visits to 24 hour care. A number of people were receiving end of life care. There were 69 people using the service at the time of this inspection.

The service had a registered manager in post prior to re-registration in May 2016. 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.

We found that people’s care was delivered safely and in a manner of their choosing. People were supported in a way that reflected their wishes and assisted them to remain as independent as possible. Staff were aware of signs of potential safeguarding issues and raised them with the service. The service had responded positively to recent safeguarding issues.

People’s medicines were managed well. Staff watched for potential side effects and sought medical advice as needed when people’s conditions changed. People and their family carers were encouraged and supported to manage their own medicines if they wished to do so.

Staff felt they were well trained and encouraged to look for new ways to improve their work. Staff felt valued by the registered manager and this was reflected in the way they talked about the service, the registered manager and the people they supported. We made a recommendation around the further development of supervision.

People who used the service were matched up with suitably trained staff to support their needs, and if people requested changes to staffing or hours of support these were usually facilitated quickly. People and relatives were complimentary of the service, and felt included and involved by the staff and registered manager.

There were high levels of contact between the staff and people with staff seeking feedback and offering support as people’s needs changed. People and their relatives felt able to raise any questions or concerns with the service and felt these would be acted upon.

When people’s needs changed staff sought external healthcare professional advice, incorporating any changes into care plans and their working practices. Staff worked to support people’s long term relationships and kept them involved in activities that mattered to them where possible. Relatives thought that staff were open with them about issues and sought their advice and input regularly.

The registered manager was seen as an experienced leader, by both staff and people using the service. They were trusted and had created a strong sense of commitment to meeting people’s diverse needs, supporting their staff and developing a better service.