This inspection took place on 23 and 31 January 2019 and was announced. This was to ensure someone would be available to speak with and show us records.

This service is a domiciliary care agency. The service provides long term domiciliary care, short term reablement services and rapid response to provide assistance to people in crisis.

Not everyone using Domiciliary Care and Prime Service receives 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.

On the days of our inspection there were 173 people using the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Accidents and incidents were appropriately recorded and risk assessments were in place. Staff understood their responsibilities with regard to safeguarding and had been trained in adult protection.

Checks were carried out to ensure staff were following the providers policies and procedures when delivering care and support to people.

Appropriate arrangements were in place for the safe administration and storage of medicines.

There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

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.

People were protected from the risk of poor nutrition. People had access to health and social care specialists.

People and family members were complimentary about the standard of care provided by Domiciliary and Care PRIME Service.

Staff treated people with dignity and respect. Supporting people to regain their independence was a key aspect of the provider’s reablement service. People’s plans and wishes for their end of life care was recorded when necessary.

Care records showed that people’s needs were assessed before they started using the service and support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any care or support and their individual wishes, needs and choices were considered.

The provider had an effective complaints procedure in place, and people were aware of how to make a complaint.

The provider had a robust quality assurance process in place. Staff said they felt supported by the registered manager. People, family members and staff were regularly consulted about the quality of the service via meetings, reviews and surveys.

This inspection took place on 2 and 7 June 2016 and was announced. We also made phone calls to staff, people and their relatives on 8, 9 and 10 June 2016.

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

Domiciliary Care and Start is a domiciliary care service provided by Gateshead Council that provides personal care to people in their own homes. At the time of this inspection, the service was providing care to approximately 260 people in the Gateshead area. The service is broken down into four separate areas; long term domiciliary care, short term re-ablement services, extra care housing and a rapid response function to provide assistance to people in crisis.

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 received regular safeguarding training and were aware of the different types of abuse people might experience. Staff were aware 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 were assessed. Where risks were identified, actions were taken to minimise these whilst also taking into account the person’s wishes.

Robust systems were in place 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.

People were assisted to take their medicines safely by staff who had been appropriately trained. Regular checks were completed of Medicines Administration Records (MAR) to check 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 were asked to give their written consent to their plan of care and staff were aware of the importance of offering people choice and respecting their wishes. Care plans were reviewed on a regular basis and people told us that when changes were requested these were made promptly.

Care workers were described as kind and caring and people told us they were treated with respect.

An external professional raised concerns with us about staff members understanding of the Mental Capacity Act (MCA). We highlighted these concerns to the registered manager who took immediate action following the inspection to ensure people using the service were not at risk of harm.

People told us they were happy with the management of the service and knew who to contact should they have any concerns. Staff we spoke with felt supported by the management and told us they were generally able to access support when they required it.

The provider had a range of systems in place for checking the quality of the service. However record keeping around actions taken to resolve areas for improvement was not clear. We highlighted this to the registered manager who agreed the documentation could be improved.

People who used the service and their families were very positive about the care and support provided. Comments included, “I am very happy with the service provided. The carers are polite and very helpful and cheerful” and “Their care is top quality but it’s not just the physical care she receives but also the mental stimulation”.

People were given all the information they needed to make an informed decision about their care and were asked to provide their consent to such care.

People were cared for effectively and care was planned for the individual.

We saw that people were protected from abuse.

There was an effective and safe recruitment process in place.

The provider had a good system in place to monitor the quality and performance of the service.