About the service: Premier Care - Halton Branch is a domiciliary care agency. This means they provide support to people in their own homes. The service is registered to provide personal care for people living with dementia, adults with learning disabilities, autistic spectrum disorder, people with a physical disability or mental health condition and people who misuse drugs or alcohol. At the time of the inspection there were 241 people receiving the regulated activity of personal care. The service is contracted to provide personal care by Halton Borough Council. Premier Care – Halton Branch then sub-contracts approximately 100 people’s care packages to another service in the area. For the purposes of this inspection, care packages that were being fulfilled by the sub-contracting company were not looked at.

People’s experience of using this service: People we spoke with told us they were happy with the care they received. Every person we spoke with said care staff were kind and caring. Most people we spoke with told us that they receive care from the same regular staff and they always arrive on time.

People told us they were supported to maintain their dignity and independence.

The service was the only provider that the local authority commissioned care to. In order to meet the needs in the local area, the registered provider sub-contracted some care packages to an external company. We found that the registered provider was not completing comprehensive quality assurance or monitoring of the sub-contractor, this is a breach of Regulation 17: Good Governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People were protected against the risk of avoidable harm, there were up to date risk assessments recorded in care files.

Medicines were safely managed, people who required time critical medication had an electronic alert set up on the care co-ordinators system to flag up if care staff were 15 minutes late arriving at their home.

The registered provider had a robust policy for the prevention and control of infection. Some people told us that care staff did not use the required personal protective equipment when assisting them with personal care.

People told us they were cared for by staff who were well trained. New care staff were safely recruited and received an induction before working unsupervised.

The registered manager completed three monthly service user surveys to gather the opinions of the people using the service.

Rating at last inspection: This was the first time this service has been inspected since they registered with CQC in February 2018.

Why we inspected: This was a planned comprehensive inspection.

Follow up: This inspection has identified a breach of Regulation 17: Good Governance of the Health and Social Care Act (2008). The service is required to submit an action plan detailing what they have put in place to mitigate this breach.