This inspection took place on 9 January 2017 and was announced. The provider was given 72 hours’ notice in order to ensure people we needed to speak with were available.

Northern Home Care Limited is a small domiciliary care agency providing personal care to older people in their own homes. At the time of our inspection the agency was delivering 51 hours of care to seven people. There were two staff (including the registered manager) employed to undertake these hours, plus one bank staff.

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.

During the previous inspection in November 2015 we identified a breach of regulation because care records were poorly organised making it difficult to access important information. At this inspection we checked records and other documentation to ensure that improvements had been made and sustained.

We found that the provider had made the necessary improvements regarding records and that this breach was now met.

At the last inspection in November 2015 we found that people’s care records did not contain sufficient person-centred information for staff to know them. This did not have any obvious impact on the care provided because staff had worked with the same people for a long time and knew them well. However, new staff would require more detailed information to be able to provide high-quality, effective care. We made a recommendation regarding this.

During this inspection we looked at care records and person-centred plans to see if the necessary improvements had been made and sustained. We saw that care records contained plans which were clearly person-centred and focused on people’s independence.

At the last inspection we found that risk assessments were not sufficiently detailed to support staff in providing safe care. We made a recommendation regarding this. During this inspection we checked what progress had been made. The provider had developed risk assessment processes to include a risk screening document. This allowed them to effectively assess a range of risk factors and establish if they required further consideration.

People we spoke with told us they felt safe. The comments that we received from people using the service and a relative regarding safety were very positive.

Northern Homecare had access to sufficient staff hours to cover its responsibilities and was actively recruiting in anticipation of growth. Recruitment procedures adhered to safe-practice guidelines.

The provider had a training plan in place and made use of e-learning to facilitate a range of course which were appropriate to meet the needs of people using the service. These included; Health and safety, equality and diversity, adult safeguarding, dementia awareness and the Mental Capacity Act 2005 (MCA).

We asked about arrangements for staff supervision and appraisal. We were told that because the service was small, there was daily contact and support available. We saw from records that more formal supervision was completed quarterly.

At the previous inspection we noted that information relating to Lasting Powers of Attorney (LPA) was not recorded in people’s care records. We spoke with the registered manager about this who confirmed that none of the people currently receiving a service had an LPA decision in place. They also confirmed that details would be recorded if the situation changed.

We asked people about the support they received to eat and drink. Each of the people that we spoke with said that they had no issues with how staff supported them or the quality of food that was prepared.

People spoke positively about the support they received with their healthcare. We saw notes

At our last inspection visit on the 17 October 2013 we found that people who used the service were at risk because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening due to a lack of staff training. We also found that appropriate policies had not been updated.

At this visit we viewed the policies and procedures held by the service and talked with three members of staff. We saw evidence which demonstrated that people who used the service were protected from the risk of abuse. The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse occurring by ensuring that staff had received appropriate training and that policies and procedures were up to date and available to staff.

Overall people were happy with the support provided. Relatives and people being supported indicated they were happy with the service provided and they liked the staff. They all especially liked the continuity of seeing the same staff especially seeing the manager on a regular basis working with the staff.

Positive comments shared by them included:

“Brilliant, they are really good”; “We are very happy with them”; “We have all the contact numbers including the managers already programmed in our phone”; “It’s good we see the same staff” and “ We see the manager and staff and they always asks us about the care provided.”

We lreviewed a sample of policy documents for procedures and guidance to help inform each staff member’s practice. The manager advised she would review all policies to ensure they were updated with all necessary information to help manage the service.

Following our visit the manager has confirmed she now has the local authorities ‘safeguarding policy’ in place and is updating the services own policy. The manager has also told us she has made arrangements to ensure that all staff are provided with suitable training in ‘safeguarding vulnerable adults.’

During our inspection visit we made telephone contact with three people who use the service and one relative. Everyone we spoke with told us they were very happy with the service provided by the agency. They said that the carers provided care and support in a sensitive and respectful way which protected their dignity. People also told us they felt involved in the planning of their care and could influence the way in which it was delivered. We were told that people felt safe and protected from potential harm. Some comments made were:

“They are marvellous, very caring and they never let you down. I don’t think we could’ve done any better”.

“They are very caring and are more like friends. They have made all the difference to us, we couldn't manage without them”.

This inspection took place on 23 and 24 Novmeber 2015 and was announced. The provider was given 48 hours’ notice in order to ensure people we needed to speak with were available.

Northern Home Care Limited is a small domicillary care agency providing personal care to elderly people in their own homes. At the time of our inspection the agency was delivering 65 hours of care to seven people, and there were three staff (including the registered manager) employed to undertake these hours.

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.

Everyone we spoke with told us they felt safe when the staff were in their homes.

Everyone we spoke with told us they always see the same staff, so they trust them and have good relationships with them.

The registered manager and the staff we spoke with felt that there needed to be more staff employed by the agency. The registered manager informed us that because they are delivering the care themselves due to being short staffed, they are not able to complete other important tasks. Such as type up changes to plan, or mintues from meetings.

People told us the staff were not required to support them with their medicines.

Staff were receiving regular supervision and appraisal. New staff were provided with a detailed induction programme, which included training in essential subjects, and on the job mentoring.

The agency had robust recruitment practices in place. Applicants were assessed as suitable for their job roles. No staff commenced duties until all satisfactory checks, including Disclosure and Barring Service (DBS) check had been received. DBS checks identify if prospective staff have had a criminal record or have been barred from working with children or vulnerable people.

The registered manager had a good understanding of The Mental Capacity Act 2005 (MCA) We could see that most of the people using the service had capacity and had consented to their care being carried out, and those who did not had family members who made decicions on their behalf who had legal authority to do so.

Staff we spoke with were happy with their rotas, and people we spoke with told us staff always came when they were expected and called them in advance if they were running late.

Risk assessment’s were in place for people and they had been reviewed, however, some of the information relating to the risk was lacking in detail.

Person centred plans did not reflect the level of knowledge the staff displayed when we spoke with them about the care they delivered. Key information was missing from these plans.

Most of the staff training was in date, however we could see some of the training dates on certificates had expired. The registed manager showed us that the staff members were due to attend the courses in the next few weeks, we saw evidence to confirm this had been arranged.

Staff told us they recieved regular supervision and we could see evidence this had taken place.

People who used the service and the staff were very complimentary about the registered manager.

There were systems and processes in place to access the quality of the service in the form of questionnaires. These were sent out to people who use the service. The completed returned questionnaires had not been analysed and a report had not been produced due to a poor return. The manager explained that due to the size of the agency, they felt face to face feedback gathering was more benifical. However this was not documented.

We saw people’s care records lacked information and were not of good standard, they were also disorganised and not well maintained.

During this inspection we identified one breach’s of the Health and Social Care Act 2008. Regulation 17 Health and Social Care Act 2008 (RA) Regulations 2014 (2) (d) Good governance .

You can see what action we told the provider to take at the back of this report.