About the service: Personal Support Service is a domiciliary care agency providing personal care to people living in four separate independent living communities owned by York City Council. The service also provides personal care at night to people living within the city of York. At the time of the inspection there were 104 people using the service.

People’s experience of using this service: This focused inspection was carried out to assess any current risks to people using the service. We therefore only looked at two domains where the key lines of enquiry are about risk and leadership of the service. No other concerns had been identified through our ongoing monitoring. Therefore, the other three domains of effective, caring or responsive were not assessed as part of this inspection. A full comprehensive inspection will be carried out at a later date.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The registered manager and the provider completed checks and audits to monitor the quality and safety of the service. However, the provider had not always identified when incidents affecting people’s safety and welfare were not reported as safeguarding matters.

Overall, there were enough staff to meet the needs of people who used the service. There were mixed responses from people about regular and consistent staff. We have made a recommendation about the deployment of staff to ensure improved consistency.

Assessments of people's needs were completed before they began to use the service. Any changes in people’s needs were followed up and acted upon.

Risks to people were assessed and most people said they felt safe and well looked after. One person said, “I feel safe, as soon as I came here I felt this is where I’m staying. I love it.” One person told us they did not get on with one staff member and this was being addressed by the management team.

Staff knew how to respond to possible harm and how to reduce risks to people. People were seen to have good relationships with staff. Lessons were learnt from complaints, safeguarding and incidents to help prevent reoccurrence in the future.

Rating at last inspection: Good (published 12 November 2018)

Why we inspected: This focused inspection was brought forward due to information of risk or concern that had been raised about the safety and management of the service.

Enforcement: We found the provider failed to notify us of two incidents which had occurred at the service across a two month period which the provider is legally required to inform us of. More information is in detailed findings below. We are dealing with this outside of the inspection process and will publish a supplementary report once we know the action we will be taking.

Follow up: We will continue to monitor this service and inspect in line with our re-inspection schedule or sooner if we receive information of concern.

Personal Support Service is a domiciliary care agency providing personal care to people living in four separate independent living communities owned by York City Council. The service also provides personal care on a night to people living within the city of York. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises, this inspection looked at people's personal care and support. Not everyone using Personal Support Service receives regulated activity; CQC only inspects the service being 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.

We completed this inspection on 14 and 20 September and 15 October 2018. At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Systems and processes were in place to support people to stay safe. Staff were trained in safeguarding and knew how to recognise and report abuse. Medications were managed in line with company policy. The service provided information to people to support them to remain safe within their homes.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff received consistent supervision meetings and felt supported in their roles. Regular team meetings supported staff to keep up to date with policy and provided information for staff to support their role. The service provided safe staffing levels.

We observed staff to be kind and caring. People told us they were happy with the service and enjoyed meaningful interactions with staff. Staff knew people well and encouraged independence at all times.

Support plans were person-centred and contained information for staff to support people in line with their needs, wishes and preferences. People were involved in reviewing their care and were assigned a ‘keyworker’ to ensure reviews were completed on a regular basis. A keyworker is a member of staff assigned to a person to provide care and assistance and encouraging them to participate in social activities and keep their support plan up to date in line with the person’s needs.

People were encouraged to join in activities which took place in communal areas within the sheltered housing schemes. A wellbeing coordinator had been employed to prevent people from becoming socially isolated.

Systems were in place to monitor the quality of the service. The management team were passionate about providing person-centred care for people living with a dementia related illness to live independently within a community based setting.

Further information is in the detailed findings below.

We inspected this service on 8 and 11 January 2016. The inspection was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the location offices when we visited.

Personal Support Service is a domiciliary care agency and is registered to provide personal care to people in their own homes. At the time of our inspection Personal Support Service was supporting 64 people who lived in their own flats across four sheltered housing schemes in York. These sheltered housing schemes were owned by City of York Council and people living there, including the people who received care and support from Personal Support Services, were tenants of City of York Council. Personal Support Service had offices at each of these four sheltered housing schemes. However, care workers were not on site 24 hours a day and only provided care and support, to some of the tenants, on a prearranged basis at certain times during the day; this was recorded in people’s care plans. Personal Support Service had no involvement in the running or maintenance of people’s flats or communal areas in the sheltered housing schemes.

Personal Support Service also supported a further 25 people living across York, with care workers visiting them during the night to provide assistance with personal care.

Personal Support Service was registered at a new location in June 2015 and this was the first inspection of the service at this location.

The registered provider is required to have a registered manager in post. On the day of our inspection, the registered manager was in the process of deregistering and a new manager had applied to become the registered manager. The registered manager, however, continued to support the new manager in the running of 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.

During this inspection we found that people’s needs were assessed and risk assessments put in place to keep people using the service safe and prevent avoidable harm.

We observed that care workers received safeguarding training and understood the types of abuse they might see and how to respond to keep people safe. Whilst a recent safeguarding investigation had identified some concerns regarding process and care workers practices, these had been addressed by the registered manager to prevent further risk of harm.

We observed that there were safe recruitment processes and sufficient care workers employed to meet people’s needs. Medication was safely managed and administered and care workers followed guidance on best practice with regards to infection prevention and control.

The registered provider provided an effective induction and on-going training to equip care workers with the skills and experience needed for their roles. Gaps in care workers training had been identified and care workers put forward for refresher training. Care workers received ongoing supervision and support in their roles.

Care workers understood the principles of the Mental Capacity Act 2005 and supported people to make decisions in line with statutory guidance.

People were supported to eat and drink enough and to access healthcare services where necessary.

There were systems in place to support care workers to develop positive relationships with people using the service. Feedback we received confirmed that care workers were kind, caring and supported people to make decisions and have choice and control over their daily lives. People using the service told us that care workers respected their privacy and dignity.

People’s needs were assessed and person centred care plans put in place to enable care workers to provide responsive care and support. The service had a system to manage and respond to compliments and complaints.

People using the service and care workers told us the service was well-led. We could see there was a quality assurance process to monitor the quality of care and support provided. We found records were not always well-maintained and supporting evidence for training, supervisions and observations was not always available.