We undertook an announced inspection of Home Care Preferred Limited on 14 August 2018. Home Care Preferred Limited provides a range of domiciliary care services which include live-in care and support, administration of medication, food preparation and housework.

CQC only inspect the service 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. At the time of inspection the service provided care to 98 people, of which 54 people received ‘personal care’.

There was a registered manager 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.

Our previous inspection of the service on 30 July 2015 rated the service as Good with no breaches of Regulation. During this inspection on 14 August 2018, we found that the service remained Good.

The majority of people who received care from the service were unable to communicate with us verbally. We therefore spoke with people’s relatives. People who used the service and relatives told us they were satisfied with the care and services provided and spoke positively about the service. People told us they were treated with respect and felt safe when cared for by support assistants and this was confirmed by relatives we spoke with. They spoke positively about them and the management at the service. The provider refers to care workers as "support assistants" and therefore for the purposes of the report we have referred to them as "support assistants".

Procedures were in place to protect people and keep them safe. Staff knew how to identify abuse and understood their responsibilities in relation to safeguarding people and reporting concerns. There were safeguarding and whistleblowing policies in place.

Risks to people's and staff safety were identified and guidance was in place to manage and minimise risks of people being harmed and protect them. We found risk assessments were comprehensive and included personalised guidance for support assistants to follow to keep people safe minimise the risk of people being harmed.

The service carried out appropriate checks so only staff who were suitable to work with people using the service were employed by the service.

Appropriate arrangements were in place in respect of medicines management. Medicines administration was recorded electronically and we noted that all records were up to date.

People had been visited by the service who carried out an assessment of their needs prior to them receiving care. People received personalised care and the service was responsive to their needs. People were consulted about how they would like to receive their care and their preferences were supported. People's care plans were up to date and included information staff needed about how best to support them. People’s daily routines were reflected in their care plans and the service encouraged and prompted people’s independence. Care support plans included information about people’s life history.

The service had an electronic system in place to monitor care worker's punctuality. People told us their care workers turned up on time and they received the same support assistant on a regular basis and had consistency in the level of care they received. Management at the service explained that consistency of care was an important aspect of the care they provided.

People were cared for by staff that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Staff spoke positively about their experiences working for the service and said that they received support from the registered manager.

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We undertook this unannounced inspection on 30 July 2015. Home Care Preferred Limited provides a range of domiciliary care services which include live-in and hourly support, administration of medication, food preparation and housework

At our last inspection on 12 June 2014 the service was found to be meeting the regulations we looked at. The service has a registered manager. Like registered providers, registered managers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act and associated Regulations about how the service is run.

People who used the service and their relatives informed us that they were satisfied with the care and services provided. They said that people were treated with respect and people were safe when cared for by the service.

People’s needs were carefully assessed. Risk assessments had been carried out and these contained guidance for staff on protecting people. Staff prepared appropriate and detailed care plans with the involvement of people and their representatives. When needed or agreed with people or their representatives, people’s healthcare needs were monitored. The arrangements for the recording, storage, administration and disposal of medicines were satisfactory. The service had an infection control policy and staff were aware of good hygiene practices.

Staff had been carefully recruited and provided with training to enable them to care effectively for people. Staff had the necessary support and supervision from their managers. They knew how to recognise and report any concerns or allegations of abuse. There were enough staff to meet people's.

People’s preferences were recorded and arrangements were in place to ensure that these were responded to. Staff were knowledgeable regarding the individual care needs and preferences of people. Reviews of care had been carried out so that people could express their views and experiences regarding the care provided. Where agreed in care arrangements, staff supported people with their meals and ensured that that people’s dietary needs were met.

The service was responsive to the needs of people. Concerns or complaints were promptly responded to. There were comprehensive arrangements for quality assurance. Regular audits and checks had been carried out by senior staff and the director. We saw a record of compliments received and these indicated that people concerned were satisfied with the quality of care provided. The service had received several awards in recognition of efficient management and the good performance of staff.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, is the service well led?

During the inspection we spoke with six people who used the service. We spoke with the registered manager, the nominated individual, the care co-ordinator, two office based staff and three care staff.

Below is a summary of what we found. The summary describes what people using the service and the staff told us and the records we looked at.

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People we spoke with told us that they were well treated by staff. One of them stated, “I feel safe with the carers and I am happy with the care provided.” A relative wrote regarding the care provided, “We feel that X is safe and content. Every effort is made by your team to enhance X’s quality of life.”

The service had a safeguarding policy and procedure. Staff had been provided with safeguarding training. They were aware of action to take in response to safeguarding incidents or allegations. Staff were aware of potential risks which may be faced by people who used the service. Risk assessments of people had been documented in their care records together with guidance on action to take to protect people. There was documented evidence that staff had been provided with essential training to enable them to care for people.

Is the service effective?

Feedback from people who used the service and from correspondence received from relatives and those involved in their care indicated that the service was effective and responsive to the needs of people. One person said, “They do a good job. They are helping me.” A second person stated, "Sometimes they are late because of the traffic, but they always turn up. They have never let me down." People’s care needs had been assessed with the help of their relatives and representatives. Their choices and preferences were documented and staff we spoke with were aware of these. This enabled staff to respond effectively when caring for people. Care plans had been prepared and these were up to date and had been regularly reviewed. Staff were knowledgeable regarding how to care for people with certain medical and mental healthcare needs. This meant that the needs of people could be met.

Is the service caring?

We saw correspondence and feedback from relatives and those involved in their care which complimented staff for being caring towards people. One person stated, “The manager has visited me to discuss my care. They have also telephoned me to check how things are.” A relative wrote, “I can’t find fault with anything. You have real care at the heart of everything you do.” Staff stated that they were aware that all people who used the service should be treated with respect and dignity. The manager and nominated person informed us that they encouraged people to be as independent as possible and had organised exercise and social sessions for people in a local hall.

Is the service responsive?

People informed us that staff were attentive and responded promptly when people had any concerns. One person said, “Staff do not always get things right and sometimes in the past there were mix-ups. I have complained and they have responded and things have improved.” The manager informed us that the provision of services and care were regularly reviewed and if there were problems or suggestions made, they would respond. This included providing specific carers who got on well with certain people and informing people if carers were going to be late. She also stated that the agency would be flexible with allocated arrival times of carers when necessary. When we needed information regarding the care provided and the management of the agency, this was promptly provided.

Is the service well-led?

The manager and the nominated individual who were present were knowledgeable regarding their roles and responsibilities. There were arrangements for monitoring the quality of care provided. A satisfaction survey had been carried out recently. The results indicated that people who used the service, their relatives and those involved in their care were satisfied with the care provided. Spot checks had been carried out by manager and senior staff to ensure that staff were providing the agreed care to a high standard. Staff we spoke with said they felt supported and they were satisfied with the management of the agency.