This inspection took place on 19 June 2017 and was announced. The last Care Quality Commission (CQC) comprehensive inspection of the service was carried out in May 2015. At that time we gave the service an overall rating of ‘requires improvement’ and found two breaches of regulation in relation to how the provider supported staff and good governance. In January 2016 we carried out a focussed inspection and found the provider had made improvements to meet the breaches of regulations and we changed the overall rating to good.

At this inspection we found the provider had maintained most of the improvements made at the previous inspection. In January 2016 we also found the provider had put in place quality assurance systems to assess, monitor and improve the quality of service provided to people. At this inspection these new systems were still in place but the improvements we saw were not sustained. A feedback survey was not carried out since December 2015. However people told us that recently improvements were made that they were happy with. We will be checking this again at the next inspection.

Home Care Service Provider provides personal care as well as general support to people such as meal preparation, prompting medicines, laundry and general household support. The registered manager told us the service provided care to 40 older adults at the time of this inspection.

At the time of the inspection, there was 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.

People and the relatives we spoke with told us they felt safe with the care and support they received. Risks were assessed to help reduce potential problems with the provision of support and we found there was a good assessment and care planning process to address their needs. People told us they found their regular staff very supportive and reliable. We found there was an appropriate method for staff recruitment that helped to ensure people’s safety. People received assistance with their medicines and the help they received was documented appropriately.

All staff received training to increase their skills and knowledge of the work. People said they felt staff were well trained and we found they were supported by staff who were supervised.

Staff showed they were aware of people’s capacity to make decisions about their care and documented this in people’s written records. People's care needs were recorded and reviewed regularly with senior staff and the person receiving the care or one of their relatives. Staff had comprehensive information and guidance in care plans to deliver care the way people preferred.

People were able to access health care professionals independently. Staff monitored people's health with their consent and could direct them to healthcare professionals as appropriate.

People said staff who supported them were caring, polite and friendly. They told us staff respected their privacy and dignity and people told us they felt listened to by staff. People were able to contribute to their care plans and make decisions about how they wanted their care and support to be provided for them. All the care plans we looked at were personalised and contained information that assisted staff to provide care in a way that respected people’s wishes. Commissioners we spoke with said they were very happy with the service provided to people.

The agency had a complaints policy and procedure that was included in people's care records. People said they were aware of the procedure and had telephone numbers they could ring to complain. People and staff said they felt confident they could raise concerns with the registered manager and senior staff. Records showed the a

We carried out an announced comprehensive inspection of this service on 29 May 2015. Two breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to these two breaches. The first breach was to do with ensuring people were protected against the risks associated with unsafe care and support as staff had not received all the necessary training and support needed for them to carry out their roles effectively. The second breach was to do with ensuring people were protected from the risks of inappropriate or unsafe care because there were not effective systems in place to regularly assess, monitor and improve the quality of the service provided.

The provider sent us an action plan and told us they would make the necessary improvements by the end of October 2015. We undertook this focused inspection 8 January 2016 to check that they had followed their plan and to confirm that they now met legal requirements. This report covers our findings in relation to those requirements and to one area of staff support that required improvement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Home Care Service Provider on our website at www.cqc.org.uk.

Home Care Service Provider is a domiciliary care service that provides personal care for people with personal care and support needs. There were 33 people using the service when we visited.

The service had a registered manager at the time of the inspection. 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.’

At this inspection we found the provider had followed their action plan and the legal requirements had been met. We saw there was in place a new staff supervision system that meant staff received regular support and appropriate monitoring of their work. From our inspection of the records and from our discussions with staff we saw this new system was started in July 2015. Staff told us they received supervision on a three monthly basis that alternated between an individual supervision meeting and a “spot check”. Staff told us they found the supervision process supported them more effectively with their work.

We saw improvements in the training of staff had been made. Training records for staff evidenced that training included moving and handling; safeguarding; medication awareness; first aid; food hygiene and health and safety. We found the induction training programme for new staff had also been revised and updated. Staff told us they found the new training programme both interesting and helpful for them in carrying out their work.

The registered manager told us all staff had an appraisal of their work that included an assessment of their training needs for the year ahead. We saw staff records that evidenced this.

The actions the provider had taken to ensure the training and supervision of staff were improved was effective. We have re-assessed the rating for ‘Is the service effective’ from requires improvement to good.

The provider had arrangements in place to assess and monitor key aspects of the service. Our inspection of the records showed that in November 2015 there was a quality assurance feedback survey of staff and of people who used the service. The results we saw were positive. The registered manager had implemented other quality assurance methods such as “spot checks” and telephone calls to people to check on their satisfaction of the services they received. These also included checks on recruitment practices, supervision practice, staff training, and client file reviews to ensure care plans and care reviews were up to date. We saw evidence that where targets had not been met, prompt remedial action was taken.

Records showed that team meetings were taking place frequently and at times to suit the different working patterns of the staff.

The actions the provider had taken have helped to ensure the quality assurance systems were more effective. We have improved the rating for ‘Is the service well led’ from requires improvement to good.

This inspection took place on 29 May 2015 and was unannounced.

Home Care Service Provider is a domiciliary care service that provides personal care for older people. There were 16 people using the service when we visited.

The service had 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.

Care workers had not received updated training in areas of their work identified as essential by the provider. They had also not received regular or documented supervision required for them to carry out their role and responsibilities effectively. This meant there were risks that care workers might not be skilled and experienced enough to meet the needs of people who use the service. When we discussed this with the registered manager, they agreed to make arrangements for care workers to receive training and regular supervision. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

The provider’s auditing systems did not check all aspects of the service. This meant there was insufficient information available to enable changes and improvements to be made to the service as a whole. Where feedback surveys had been carried out action plans had been made to address any issues raised. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

People and their relatives told us they felt safe with the service they received at home. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service, their relatives and staff about how to report suspected abuse.

People had risk assessments and risk management plans to reduce the likelihood of harm to them. Staff knew how to use the information to keep people safe.

The registered manager ensured there were safe recruitment practices to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

People were involved in planning their care and their views were sought when decisions needed to be made about how they were cared for. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.

Care workers respected people’s privacy and treated them with respect and dignity.

People indicated that they felt that the service responded to their needs and individual preferences. Our findings during the inspection show that care workers supported people according to their personalised care plans.

People received the support they needed to maintain good health. Care workers accompanied people to their health appointments where necessary and to meet people's needs. As part of the care package care workers helped to support people to eat a healthy diet which took account of their preferences and nutritional needs.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner. People were aware of the complaints policy.

People gave positive feedback about the management of the service. They told us the registered manager and the care workers were approachable and fully engaged with providing good quality care for people who used the service.

The provider’s auditing systems did not check all aspects of the service. This meant there was insufficient information available to enable changes and improvements to be made to the service as a whole. Where feedback surveys had been carried out action plans had been made to address any issues raised.

When we visited the offices of this service, the registered manager told us that 30 people were using the service. We spoke with four of the people using the service, the registered manager and two other members of staff. We reviewed four people's care plans and four staff files.

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Was the service safe?

People who use the services were treated with respect and dignity by the staff. They told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff had been trained to understand when an application should be made and the process for submitting an application. This meant that people were safeguarded as required.

Recruitment practice was safe and thorough. The registered manager ensured that staff were appropriately qualified to meet the care needs of people who used the services. This helped to ensure that people’s needs were met.

Was the service effective?

People who use the services' health and care needs were assessed with them, and they were involved in their care and support planning. People told us that they had been involved in their care and support plans and that the plans reflected their needs. We inspected four people’s care files. They included essential information about the person, needs and risk assessment information and service delivery or care plans.

Staff received regular and appropriate training and supervision to ensure they were able to meet the specific needs of people using the service.

Was the service caring?

People who use the services were supported by kind and attentive staff. The four people we talked to said the staff treated them well and respected their privacy. One person said, "My care worker is very good, I couldn’t manage without her”. Another person told us, "I like my care-worker she goes above and beyond what I had expected before”.

People who use the services told us they had discussed their care planswith the office and that they were able to discuss relevant issues and make decisions about what they wanted to do. This reflected the caring environment that we found on the day of the inspection.

Was the service responsive?

People who used the services were able to ask for changes in their care and support as their needs changed. Care plans were reviewed regularly and people told us that they felt well supported.

All the people who use the services we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place and although no complaints had been made since the last inspection staff indicated that they would be supportive of anyone who needed to complain. People can therefore be assured that complaints would be investigated and action taken as necessary.

Is the service well-led?

We saw that the service worked well with other agencies and services to make sure that people were supported in a co-ordinated way. It was clear that the main objective was to support people in relation to maintaining and developing their independence.

The registered manager carried out regular checks to assess and monitor the quality of services provided and took appropriate action to address any issues or concerns raised about service quality.

The views of people who use the services, their representatives and staff were listened to by the manager. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the agency. This helped to ensure that people received a good quality service.

At our previous inspection of Home Care Service Provider we identified that action needed to be taken by the service provider to improve care planning and support provided to people who used the service. We also found that improvements were required for safeguarding practices within the agency and to do with the training, support and development of it's staff. During our follow up visit we found that appropriate action had been taken by the provider to address these concerns identified at the previous inspection.

The four people who we spoke with regarding their care told us that they had a support plan that worked well for them. One person said, “Yes I have a plan that sets out what my carer does for me and what I need to be done. Mostly that’s what gets done unless on rare occasions I ask for them to do something else”. Another person said, “I have a care plan and the carers sign the diary sheets every time they visit that explains what they have done for me on the day”.

The managers told us that the agency’s safeguarding policies and procedures had been revised to meet the necessary requirements and staff told us that they now received improved supervision and access to training. An application for the registration of the manager had been submitted to the Commission.

We spoke with six people who use the services and two relatives and they told us that overall they were happy with the services they received. People informed us that they had care plans in place and that they had been involved in the care planning process. They said that their care workers usually arrived on time, carried out their work with kindness and sensitivity and did all the work that had been agreed with them in their care plan. People said that care workers did wear their identity badges but did not wear a uniform. It was confirmed by the provider that staff do not wear uniforms but wore identity badges. One person said, “Sometimes the office did not inform me of when my carer was going to be late” but other people said their care workers arrived on time.

Although people who used the service told us that they were happy, we found that peoples needs may not always be fully met because needs and risk assessments were not always as thorough as might be needed for a person with complex needs and care plans had not always been reviewed regularly.

People who used the service were not being adequately protected from the risk of abuse because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Staff needed to be better supported through regular and effective supervision and annual appraisals.

We carried out a themed inspection looking at domiciliary care services. We spoke to 13 service users and 2 relatives of service users. We spoke to senior staff, including the Owner and the Manager of this service and we spoke to 3 care workers.We also spoke to 3 people in their homes.

We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. Everyone we spoke to said that they were treated with dignity and respect.

All of the people we spoke to said that the care and support they had received met their needs and they said they felt they had enough choices about how their care was delivered. One person said, “They come at a time that best suits me”. Another person said, “Yes I’m happy with the choices I’ve been given about my care”.

A few people could not remember whether they had been involved in any care planning but they said that they would talk to their carers or the office if they needed to. Most people said that they remembered having discussions about their care plans, one person said, “Yes the care plan was all sorted with us all together”.

All the people we spoke to said that they felt safe and comfortable with their current care workers. No one felt that they had been taken advantage of in any way.

All of the people we spoke to said they felt that their care workers were sufficiently trained to meet their needs.

The inspection team was led by a CQC inspector joined by an “Expert by Experience”; people who have experience of using services and who can provide that perspective and a professional advisor.”

We carried out a themed inspection looking at domiciliary care services. The inspection team was led by a Care Quality Commission inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We spoke on the telephone with 13 people who use the service or with their main carers. We also spoke with three people in their homes to gain their views about the service. People told us that they were treated with dignity and respect. They said that the care and support they had received met their needs and they said they felt they had enough choices about how their care was delivered. One person said, “I’ve got my information folder and my care worker comes at a time that best suits me”. Another person said, “yes I’m happy with the choices I’ve been given about my care”.

Three people could not remember whether they had been involved in any care planning but they said that they would talk to their carers or the office if they needed to. Ten people said that they remembered having discussions about their care plans. One person said, “yes the care plan was all sorted with us all together”.

The people we spoke with said that they felt safe and comfortable with their current care workers. No one felt that they had been taken advantage of in any way. One person said, “of course, if I didn’t feel safe I would either have contacted the manager or if that wasn’t successful I’d have changed the service”. Another person said, “I don’t have any worries, I’m very pleased with the service I get”.

People told us they were given information about Home Care Service Provider that helped them decide to use the agency.

People said staff listen and help and maintain their privacy and dignity.