We undertook an announced inspection of Essential Care and Support Limited on 24, 25 January and 1 February 2018. The provider was given 48 hours’ notice of our visit. We wanted to be sure there would be someone at the office to meet us.

Essential Care and Support Limited is a domiciliary care agency based in Seaham, County Durham. It provides personal care and support to people living in their own homes or in small groups, referred to as an independent supported living scheme. Different levels of support are provided over the 24 hour period dependent upon people’s requirements. Many of the people are tenants of their home and pay rent for their accommodation which is leased from housing associations.

At the time of our inspection the service provided personal care to 95 people, the majority of whom required help to maintain their independence at home. 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 had a registered manager. 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.

Essential Care and Support Limited was last inspected by CQC on 22 October 2015 and was rated Good. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risk 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.

People who used the service told us they felt safe. Relatives and external professionals expressed no concerns regarding safety.

The registered manager understood their responsibilities with regard to safeguarding. Staff had received training in prevention of abuse and were knowledgeable in recognising signs of potential abuse and the relevant reporting procedures.

Accidents and incidents were appropriately recorded and risk assessments relating to the environment and the delivery of care were in place.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

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

There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes to appointments as requested by the people who used the service.

People who used the service, relatives and external professionals were extremely complimentary about the standard of care provided by Essential Care and Support Limited. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

People who used the service received effective care and support from well trained and well supported staff. New staff completed a thorough induction into the service and mandatory training was up to date. Staff received regular supervision sessions and an annual appraisal.

Care and support plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. The plans made good use of personal history and described individuals care, wellbeing and support needs. Staff knew the people they were supporting and provided a personalised service.

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

We undertook an announced inspection of the Essential Care and Support Limited on 22 October 2015. We gave the provider 48 hours’ notice of our visit because the registered manager is often out of the office supporting staff and we needed to be sure that they would be available.

Essential Care and Support Limited is registered to provide personal care to support people to continue living in their own homes or in small groups, referred to as an independent supported living scheme. Different levels of support are provided over the 24 hour period dependent upon people’s requirements. Many of the people are tenants of their home and pay rent for their accommodation which is leased from housing associations.

Essential Care and Support Limited was last inspected by CQC on 9 September 2013 and was meeting the regulations inspected. At the time of our inspection the service was providing support to eighty people.

People who used the service were complimentary about the standard of care and support provided by Essential Care and Support Limited. A person told us, “I find the workers here very good, if I ask for anything it’s done”.

The service had a registered manager. 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 registered manager was accessible and approachable. Staff and people who used the service felt able to speak with the registered manager and provided feedback on the service. The registered manager undertook regular spot checks to review the quality of the service provided.

People were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate last minute changes to appointments as requested by the people who used the service.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Staff were knowledgeable about their roles and responsibilities and raining was up to date. Staff had the experience required to support people with their care and support needs.

Staff received supervision and appraisal which meant that staff were properly supported to provide care to people who used the service.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. Care plans were written in a person centred way and were reviewed regularly or when people’s needs changed.

Staff supported people to help them maintain their independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.

The arrangements for supporting people to make decisions about their daily lives and preferences were recorded in their care plans. Each person was supported to take appropriate risks to promote as much independence as possible.

Suitable arrangements were in place for people to take part in activities in line with their needs and preferences.

The relationships between staff and the people who lived there were good and support was provided in a way that promoted and protected their privacy and dignity.

Suitable arrangements were in place for handling complaints and for protecting people from abuse. Two people told us they could share any concerns with the staff and felt their views were listened to.

Staff told us they were supported by the provider including training on the principles of care, safe working practices, and around the particular and complex needs of the the people who used the service.

At our last inspection carried out in September 2012 we identified concerns with outcome 14 (HSCA Regulation 23) supporting workers. We found the provider did not ensure staff were properly trained, supervised and appraised.

During this inspection we spoke with the director of the service and the training manager. They told us training was on-going. We looked at the staff training records which confirmed staff had completed a range of training. This included training on risk assessments, report writing, challenging behaviour, autism, non-violent crisis intervention, dignity, respect, equality, deprivation of liberty safeguards and the Mental Capacity Act. We saw the majority of staff employed had achieved NVQ level 2 in care.

We also saw staff had annual refresher training in health and safety issues, for example, moving and handling and food hygiene and medication. This meant the service enabled staff to take part in training which was relevant and appropriate to their roles, so they could carry out their jobs effectively.

The training manager told us all staff had regular meetings with a senior member of staff. They included looking at the staff member's performance and any problems they had as well as achievements and training needs.

The manager told us they always ensured they carefully assessed the care and support needs of people wishing to use the service. All people their relatives, representatives’ and health care professionals, where necessary were involved in this process. We saw detailed care plans, these described the actions staff needed to take to meet people's needs. This meant staff had the information they needed to support each person and keep them safe.

We found some accredited training for staff had not been kept up to date and this could compromise the care and welfare needs of people who used services.

Suitable arrangements were in place for handling complaints and for protecting people from harm. People told us they could share any worries with the staff and felt their views were listened to.

People told us they were very happy with the care and support they received.