This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults.

At the time of inspection, there were 84 people receiving personal care services from the provider. Not everyone who used Apex Prime Shirley received support in the form of a regulated activity CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service was rated Requires Improvement at its last inspection in April 2017 and had breached one registration regulation regarding submitting notifications of serious incidents that occurred. Following the last inspection, we asked the provider to complete an action plan to show what they would do to meet the breach and improve the key questions of Well-Led to at least Good. At this inspection, we found that the provider had made improvements needed to meet the requirements of this regulation. The registered manager had a sound knowledge of their responsibilities of notifying CQC about significant incidents and had made these notifications in good time.

There was a registered manager in place. 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 that the registered manager had made improvements to the service since starting their role. These included improving consistency of staffing, improvement reliability of service in providing care calls and also improving communication between the provider and people.

The registered manager had made improvements to the system of auditing people’s care documentation. They had implemented training and a new system which was more robust in picking up errors or omissions.. The registered manager held regular staff meetings where feedback from people, complaints or issues about the quality of care were discussed and reviewed.

The registered manager had reduced instances where there were missed calls. All instances of missed calls were investigated to reduce the likelihood of reoccurrence. The provider had recently implemented an electronic call monitoring system which would alert the provider if staff did not arrive at their care calls at the agreed time.

Some people told us they did not receive a rota detailing the time of their care calls. The provider told us this facility was available to people upon request and the registered manager would ensure this service was offered to people and regularly reviewed. However, people told us they had consistent care teams who arrived at consistent times and therefore the impact of not receiving a schedule of visits was minimal.

During the inspection, the provider made the arrangements to ensure that the service’s previous inspection rating was clearly displayed on their website. This meant that by the end of the first day of inspection the provider was meeting the requirements of the regulation to display their rating in the office and on their website.

The registered manager had plans in place to ensure that people’s care needs were met in the event of an emergency. They had put plans and risk assessments in place to help ensure that the most vulnerable people had their care prioritised in the event of extreme circumstances.

Other risks to people’s health and wellbeing were assessed and monitored. This included the risks associated with staff not being able to enter people’s property at agreed times. The provider had a service which people and staff could contact outside office hours, which meant that senior management were available to offer support and guidance if required.

The level of sup

This inspection took place on 07, 10 and 11 April 2017 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own homes. At the time of our inspection the service was providing personal care to 164 older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

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 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 had not submitted notifications when required. Improvements were needed to ensure that all of the required checks were made before new staff started working at the service.

People and their families expressed mixed views about whether the service always provided their care at a time of their choosing. People did not have confidence in the out of hour’s service provided.

People and their families told us they felt safe and secure when receiving care and that staff were caring and responsive to their needs.

People received their medicines safely and staff contacted healthcare professionals when required. Staff received training in safeguarding adults. They completed a wide range of training and felt it supported them in their job role.

New staff completed an induction designed to ensure staff understood their new role before being permitted to work unsupervised. Staff told us they felt supported and received regular supervision and support to discuss areas of development. There were sufficient numbers of staff to maintain the schedule of care visits to meet people’s needs.

People who used the service felt they were treated with kindness and said their privacy was respected. Staff had an understanding of legislation designed to protect people’s rights and were clear that people had the right to make their own choices.

Staff knew what was important to people and encouraged them to be as independent as possible.

Staff were responsive to people’s needs which were detailed in people’s care plans. Care plans were regularly reviewed to ensure people received personalised care. A complaints procedure was in place.

Staff felt supported by the manager and could visit the office to discuss any concerns. Procedures were in place to investigate complaints and learn from any accidents or incidents.

We identified one breach of regulations. You can see what action we have told the provider to take at the back of this report.