We undertook an announced inspection of Privilege Care on 27 February 2018. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. On the day of our inspection six people were living at the service.

At our previous inspection on 18 September 2015 we found that not all training was up to date and staff were not offered the opportunities through appraisal or supervision to identify and develop their knowledge and skills. This was a breach of Regulation 18, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection we found supervision and appraisal of staff had improved as had the majority of training. However staff had still not received training in Mental Capacity Act 2005.

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.

There were arrangements in place to keep people safe and to help safeguard people from the risk of abuse. Staff understood their responsibilities for safeguarding people from harm and followed the registered provider's policy and procedure. Potential risks associated with people, the environment and equipment had been identified and managed.

People's needs and choices continued to be assessed when they started using the service. People received care that was personalised to their needs. People were encouraged to raise concerns or complaints and were asked for feedback about the service they received.

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

People were involved in their care. Care plans were personalised and reflected people’s current needs and preferences. They contained the information staff needed to provide people with the care and support they wanted and required. Staff understood the importance of treating people with dignity and respect. People and relatives had developed positive relationships with care staff and management.

Staff were positive about the support and development opportunities they received. The registered provider had not ensured staff had all the skills and knowledge to meet people's needs as staff had not received training in the Mental Capacity Act 2005.

There were systems to monitor and improve the service, which included systems to gather people's feedback about the service. The registered manager carried out checks to monitor and improve the quality and safety of the service. However, the registered manager did not always take action to address issues and make improvements when needed. For example, despite training in Mental Capacity Act 2005 being highlighted at our inspection of September 2015 staff had still not received training in this area.

Further information is in the detailed findings below.

The inspection took place on 18 September 2015 and was announced. The provider was given 48 hours’ notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies. The service had previously been inspected on 07 November 2013 and met all the statutory requirements.

The service was first registered in in 2010 and provides care and support to people in their own home. On the day of our inspection five people were receiving support.

There is no requirement for this service to have a registered manager as the registered provider manages the service on a day to day basis.

Staff had received training in safeguarding vulnerable adults and all the staff we spoke with were able to describe what actions they would take if they suspected abuse to ensure the people they supported were safe from harm.

Staff had not received training in the Mental Capacity Act 2005 and therefore could not evidence they were acting in line with legislation. Not all training was up to date and staff were not offered the opportunities through appraisal or supervision to identify and develop their knowledge and skills. And although staff told us they were happy with this situation this demonstrated a breach of Regulation 18, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Spot checks and supervision of the current practice of staff was undertaken regularly to ensure staff were practising safely.

Staff were knowledgeable about people’s needs and told us they always aimed to provide personal, individual care to people. Staff told us how people preferred to be cared for and demonstrated they understood the needs and preferences of the person they cared for.

People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and the care package amended to meet their changing needs. Care was personalised and tailored around the needs of the people who used the service.

The feedback we received from people who used the service and their relatives was excellent.

They expressed great satisfaction with the service and spoke very highly of the registered provider and staff.

You can see what actions we asked the registered provider to take at the end of the report.

We spoke with the manager of the service, two care staff and with two relatives of people who used the service. We spoke with one person in their own home and observed positive staff interaction with them.

We found people were consulted and informed about the care they wanted. Their individual care plans illustrated their needs and how these were to be met by staff.

Staff we spoke with told us they enjoyed their role and knew the people they cared for, which meant they could meet individual needs.

One person we spoke with said staff were reliable and knew what they wanted. This person said they were always asked about their care and their consent was obtained.

We spoke with two relatives of people who used the service; one relative we spoke with in their own home and the other over the telephone. Both relatives said care staff were reliable and they regarded them as family members because they knew their relatives so well.

We found staff were robustly recruited and their suitability was monitored. We saw evidence to show how the quality of the provision was monitored and maintained.

We arrived at the providers location address to undertake an unannounced inspection on the 05 February 2013. On arrival, we found the offices closed. We left a message for the provider to contact us as soon as possible to arrange the inspection. The provider contacted us a couple of days later and told us that due to personal circumstances, they had been unable to attend the office and was covering the service remotely from home. We arranged to inspect the service on the 12 February 2013, therefore the inspection was announced.

On the day of the visit, we met with the Registered Manager who told us they currently employed nine care staff, who provided personal care for people with learning and physical disabilities. At the time of our visit four people were using the service and the manager told us that all four had specific religious and cultural needs.

We spoke with the next of kin for one person who used the service. They told us they were very satisfied with the service they said, “The carers are brilliant they are like part of the family”.

The service only has four people that they provide care for; we did not speak to them during this inspection. However, the service carried out a questionnaire where people were generally positive about the service they had received.