The inspection was carried out on 6 July 2018, and was an announced inspection.

First Class Healthcare is a domiciliary care agency registered to provide personal care for people who require support in their own home. CQC only inspects the service being received by people provided with ‘personal care’ and help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. This was the first comprehensive inspection since the agency was registered on 11 July 2017. At the time of our inspection, the service was supporting 11 elderly people.

The provider was also the registered manager at the service. 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 Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The provider understood their responsibilities under the Deprivation of Liberty Safeguards. People’s capacity to consent to care and support had been assessed and recorded within their care plans.

The provider had suitable processes in place to safeguard people from different forms of abuse. They knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider and staff recognised the signs of abuse and what to look out for. There were systems in place to support staff and people to stay safe.

The provider and care co-ordinator involved people in planning their care by assessing their needs on their first visit to the person, and then by asking people if they were happy with the care they received. There was a strong emphasis on person centred care. People were supported to plan their support and they received a service that was based on their personal needs and wishes. The service was flexible and responded positively to changes in people’s needs. Some people were supported by their family members to discuss their care needs, if this was their choice to do so. People told us they were able to express their opinions and views and were encouraged and supported to have their voices heard.

People were supported with meal planning, preparation, eating and drinking as necessary. Staff supported people, by contacting the office to alert the provider to any identified health needs so that their doctor or nurse could be informed.

Staff provided caring and considerate support and respected people’s privacy and dignity.

At this time, the service did not provide care and support to people who were at the end stages of life.

The provider had followed effective recruitment procedures to check that potential staff employed were of good character and had the skills and experience needed to carry out their roles.

The provider deployed sufficient numbers of staff to meet people’s needs and provide a flexible service.

Staff had received training to enable them to carry out the duties they were employed to perform. All staff received induction training at the start of their employment. Refresher training was provided at regular intervals.

Staff received regular supervision and an annual appraisal so they were supported to carry out their roles.

Staff followed an up to date medicines policy issued by the provider and they were checked against this and assessed by the provider. Management systems were in use to minimise the risks from the spread of infection. Staff received training about controlling infection and had access to personal protective equipment like disposable gloves and apron’s.

People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues.

The provider had processes in place to monitor the deliver