About the service: First Call Healthcare Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older adults including people who live with dementia or learning disabilities. At the time of inspection 43 people were using the service.

People’s experience of using this service: People said they felt safe with the service provided. They trusted the workers who supported them. There were sufficient staff hours available to meet people's needs in a safe and consistent way, and staff roles were flexible to allow this.

Staff had received training about safeguarding and knew how to respond to any allegation of abuse. There were other opportunities for staff to receive training to meet people’s care needs.

Communication was effective and staff and people were listened to. Staff said they felt well-supported and were aware of their responsibility to share any concerns about the care provided.

All people were complimentary about the care provided. They said staff were kind, caring and supportive of people and their families. Privacy and dignity were respected and people’s independence was promoted.

The service assisted people, where required, in meeting their health care and nutritional needs. Staff worked together, and with other professionals, in co-ordinating people’s care.

Systems were in place for people to receive their medicines in a safe way. Risk assessments were in place and they identified current risks to the person as well as ways to keep them safe.

People were involved in decisions about their care. They 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. Information was accessible to involve people in decision making about their lives.

People's views and concerns were listened to and action was taken to improve the service.

The provider undertook a range of audits to check on the quality of care provided.

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

Rating at last inspection: At the last inspection the service was rated good (27 August 2016.)

Why we inspected: This was a planned inspection to check that this service remained good.

Follow up: We did not identify any concerns at this inspection. We will therefore re-inspect this service within the published timeframe for services rated good. We will continue to monitor the service through the information we receive.

We had carried out an announced comprehensive inspection of this service on 28 and 29 June 2016 and found a breach of legal requirements regarding the management of medicines.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on 19 April 2017 to check that they had followed their plan and whether they now met legal requirements.

This report only covers our findings in relation to this requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for First Call Healthcare Limited on our website at www.cqc.org.uk.

First Call Healthcare Limited is a domiciliary care service that provides personal care and support to people living in their own homes. There were 50 people using the service, mainly older people, at the time of our inspection.

A registered manager was in post. 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 the provider had followed their action plan and the service’s arrangements for managing people’s medicines were more fully robust.

The inspection took place on 28 and 29 June 2016 and was announced. We had last inspected First Call Healthcare Limited in August 2014. At that inspection we found the service was meeting the legal requirements in force at the time.

First Call Healthcare Limited is a domiciliary care agency that provides personal care and support to people living in their own homes. At the time of our inspection services were provided to 14 people, who were mainly older people including those who were being cared for at the end of their lives.

The service had a manager in post who had applied to become the 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.

We found that care was appropriately planned to protect people’s welfare and personal safety. Steps had been taken to reduce the risks of avoidable harm and safeguard people from being abused. Staff understood their roles in recognising and reporting any concerns about people’s safety.

There was sufficient staffing capacity for people to be provided with safe and consistent care. New staff were properly checked and vetted to make sure they were suitable to be employed to work with vulnerable people. Staff were supervised and given training to enable them to meet the needs of the people they cared for.

Where required, people received assistance to meet their nutritional needs including support with eating and drinking. People were well supported in meeting their health care needs and staff worked in a co-ordinated way with families and other professionals. However, the arrangements for managing people’s prescribed medicines were not fully robust.

People and their families were consulted about their care and how they preferred to be supported. Wherever possible, services were provided flexibly and adapted in line with people’s needs and requests. Staff confirmed they were given enough time and information to provide people with effective care.

Supportive relationships had been developed between staff and the people and families they worked with. Staff were described as having a caring approach and being respectful of people’s privacy, dignity and independence. A number of relatives spoke positively about the personalised care they felt their family members received.

Care plans were tailored to the person, had been agreed with them and their family, and were kept under review. Good communication systems were in place to keep check on people’s well-being and respond to any concerns. People were informed about the complaints procedure and were regularly asked for their views about their care experiences.

The manager promoted an open culture and provided staff with leadership and support. Methods to monitor the quality of the service were in place, including routine checks to ensure staff met the provider’s standards. A commissioner of the service spoke highly of the way the service was managed and operated.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to the safe management of medicines. You can see what action we told the provider to take at the back of the full version of the report.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found -

Is the service safe?

The service identified and managed risks to ensure people’s care and support was provided safely. People told us they felt safe with their care workers. There were appropriate arrangements to protect people from being harmed and to respond to any allegations of abuse. The suitability of new staff to work with vulnerable people was checked before they were employed.

Is the service effective?

Everyone we spoke with said that they were happy with the care and support they received. They had regular care workers who were reliable and who understood and met their needs. One person told us, “I’m more than happy with the care and my care worker. She encourages me in every way”. Another person commented, “They’ve been great, there’s never been any problems”.

Is the service caring?

People were supported by kind and attentive staff. They told us their care workers were caring, knew them well and treated them with respect. One person told us “They’ll do anything you ask, they’re really nice”, and a relative said, “They always cover everything that’s in the care plan”.

Is the service responsive?

People’s needs were properly assessed before they started to receive services. Records confirmed that care and support was planned and provided according to each individual’s preferences and diverse needs. One person said, “My support has been tailored to me and it’s been spot on”. People told us their services were able to be arranged flexibly to fit in with their needs and wishes. There was a clear procedure for making complaints and any concerns were taken seriously and acted on.

Is the service well-led?

There was a registered manager in post who promoted the ethos of the service. People and their relatives were regularly consulted about their satisfaction with the service. Quality assurance processes were also in place to monitor the care and support people received and make sure standards were maintained.

People who used the service and their representatives were supported to be involved in making decisions about their care.

We found that people’s care was planned in a safe and personalised way to meet their needs.

There were suitable arrangements for assisting people to take their prescribed medicines safely.

Staffing was properly organised and people had allocated care workers who provided them with reliable and consistent support.

Systems were in place to monitor and assure the quality of the service that people received.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.