We inspected Firstpoint Homecare Darlington on 17 July 2018. This was an announced inspection so that people could be informed that we wished to speak with them in their own homes.

Firstpoint Home care Darlington is a domiciliary care agency. It provides personal care to people living in their own homes in Darlington, Catterick, Richmond and Northallerton areas. This area includes local towns, villages and more rural areas in North Yorkshire. On the day of our inspection there were 56 people using the service.

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.’

We inspected the service in April 2016 and rated the service as ‘Good’. At this inspection we found the service remained ‘Good’.

People and relatives felt the service was safe. Staff were trained in safeguarding and understood the importance of acknowledging poor practice and reporting their concerns to the registered manager.

Staff supported people with their medicines in a safe manner. The provider had systems in place to record accidents, incidents and safeguarding concerns. Infection control procedures were followed. Staff had access to personal protective equipment. Contact numbers were available for staff in case of an emergency.

Staff were trained in a range of subjects to meet the needs of the service. Staff felt supported and received regular supervision. People were supported to access health care professionals where necessary.

Staff provided support and guidance with nutritional needs where necessary.

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. Staff gained consent before any intervention with the person.

People and relatives felt staff were caring. Staffing rotas were developed to ensure staff had time to meet the needs of people using the service.

Staff respected people’s privacy and dignity ensuring their independence was promoted.

Care plans were individualised and contained information on how to support the person in a person centred way. The provider used a variety of methods to gain information when developing support plans. For example, information from family members and health and social care professionals. People were involved in how they preferred their support to be delivered.

The provider had a system and process in place to manage complaints. The service was implementing training for staff on end of life care.

The provider had a quality assurance process in place to ensure the quality of the care provided was monitored. People and relatives’ views and opinions were sought and used in the monitoring of the service.

Staff felt the registered manager was open, approachable and supportive.

This inspection took place on 19 and 26 April 2016. We gave the provider 24 hours’ notice of the inspection to ensure someone would be available.

Firstpoint Homecare Darlington provides personal care to people in their own homes. On the day of our inspection there were 84 people using the service.

The service did not have a registered manager in place. 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 service did have a manager in place who had applied to be registered with CQC.

Firstpoint Homecare Darlington was last inspected by CQC on 15 April 2014 and was compliant with the regulations in force at that time.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and staff and described potential risks and the safeguards in place. Staff had been trained in safeguarding vulnerable adults.

Medicines were stored safely and securely and procedures were in place to ensure people received medicines as prescribed.

There were sufficient numbers of staff on duty in order to meet the needs of 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 suitably trained and received regular supervisions and appraisals.

The provider was working within the principles of the Mental Capacity Act and consent to care and treatment was documented in people’s care plan documents.

People who used the service, and family members, were complimentary about the standard of care provided by Firstpoint Homecare Darlington. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person centred way.

People who used the service, and family members, were aware of how to make a complaint and an appropriate complaints procedure was in place.

Staff felt supported by the manager and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We spoke with a sample of people who used the service. They all agreed that they had given consent for the care and treatment provided. These are some of the comments they made "They are very polite, you tell them what you want and they do it " and "They always ask do you want..." and "They ask if I am happy with what they do". One relative told us "They ask ( my relative) if they want their pain killers"

People experienced care, treatment and support that met their needs and protected their rights. People who used the service told us "My carers come every morning, I am very happy, they are all good, they provide personal care." and "I have it all ready for them, they are a lovely lot I have no cause for complaint".

There were enough qualified, skilled and experienced staff employed to meet people’s needs. A system was in place to make sure that there were enough carers employed to cover the calls they were contracted to provide. The people who used the service told us that in general time keeping was okay.

The statement of purpose did not contain all of the information required by regulation and the registered person did not regularly assess and monitor the quality of the services provided.

Complaints were responded to but accurate records were not kept about peoples' care and treatment or the management of quality.

With their advance agreement we contacted and spoke with one person about the service they received, and we also talked with the relatives of two people.

People were happy with the service. One person told us that they “accepted what they got”. Relatives told us that the service was “generally alright” and “pretty consistent”. They said that the service “understood their relatives care needs”.

Relatives also told us that they were involved in their relatives care plans and they were regularly re assessed and they attended those meetings. They also told us that staff knew all the “little things” that their relative liked. They told us how they had received surveys about individual carers from the agencies’ office asking for their thoughts on them and the service.

One relative told us that it would be easier if all of the carers could drive as their relative had a mobility vehicle which was insured for carers to drive. One relative told us that there had been some late calls to their mother. We brought this to the attention of the manager.

An inspector visited this service which helped us gather evidence against the outcomes we inspected to help answer the five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service and staff who worked there, and looking at records.

Is the service caring? – Comments we received from one relative of a person who used the service were very positive. They told us they were “really happy” with the service and their support was “very courteous” and “very caring”. We saw that care plans were written with the person they were supporting and their carers and that peoples preferences were clearly recorded.

Is the service responsive? - The service had a complaints procedure in place and this was shared with people as part of their initial assessment. We saw complaints were clearly recorded and actioned. The manager told us that the service reviewed people who received a service on an ongoing basis and sought their views about the quality of the service they felt they received.

Is the service safe? – The service had safeguarding policies and procedures in place and the manager and staff we spoke with knew how to respond to any concerns that were raised with them. We saw recruitment checks were undertaken with staff members to ensure they were able to work with vulnerable people and staff were also supported with policies and training in lone working. Risk assessments were carried out to ensure that both people and staff members maintained a safe working environment.

Is the service effective? – Care plans and risk assessments were written with the person receiving the service, their family and carers. We saw that people's wishes and preferences were clearly recorded. People were also supported to give their consent so information the service held about people was used appropriately with staff and other professionals on a need to know basis.

Is the service well-led? – The branch manager had been in post for two months and was in the process of applying to be registered with the Care Quality Commission. Policies and procedures were in place and were stored electronically so they were always up to date. The manager had begun a programme to undertake quality checks and to get formal feedback from people using the service in a more structured way. We will review how the service has continued to implement its quality assurance process on our next visit.