The inspection took place on 13 and 18 April 2017 and was unannounced.

PRN Home Care provides personal to people in their own homes. At the time of the inspection personal care was provided to 86 people whose ages ranged from 39 to 97 years and had needs such as physical disability, sensory impairment, dementia and frailty due to old age

The service had 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.

At the last inspection carried out on the 7 August 2014 the service was rated Good. At this inspection we found the service remained Good.

We carried out this inspection as part of our routine schedule of inspections and to check that people were still receiving a good standard of care.

Staff were trained in adult safeguarding procedures and had a good awareness of what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe with the staff which was also echoed by their relatives

Care records showed any risks to people were assessed and there was guidance of how those risks should be managed to mitigate any risks of harm. People said they received safe care.

There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures ensured only suitable staff were employed.

Medicines were safely managed.

There was a good system of training and supervision of care workers.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005. The staff and deputy manager were aware of the principles of the MCA and made referrals to social services where it was assessed people did not have capacity to consent. However, the service did not have a set procedure for assessing and recording capacity and training in this for staff was limited. The deputy manager took immediate steps to address this by arranging staff training in the MCA.

People’s consent to care was sought and this was recorded in the care plans.

People were supported with food and drink where this was needed.

People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed. Staff worked well with health care services such as community nurses to ensure health care needs were met.

People were treated well by the staff who formed positive relationships with people. Care workers treated people with respect and dignity and promoted their privacy.

People received individualised care based on their needs and preferences, which was reflected in their care plans. People said they were involved in decisions about their care and knew how to make a complaint if they needed to.

The service had good systems to monitor its own performance to ensure care was reliable and safe. These included seeking the views of people who received care, their relatives and health and social professionals. Audits were also used to monitor the effectiveness and quality of the service and action was taken where any shortcomings were identified.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection took place on the 7 August 2014. This was an announced inspection. The provider was given 48 hours’ notice of the inspection as we needed to be sure that the office was open and staff were available to speak with us.

PRN Homecare is a domiciliary care service that provides nursing and homecare services to adults within their own homes. PRN Homecare staff support people with a variety of needs including those related to living with dementia, mental health, older age, physical disability or sensory impairment. At the time of our inspection the service supported 118 people.

There was a registered manager in place for the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People and their relatives told us they were happy with the service they received. One person told us, “PRN are superb. They are flexible and every single carer I’ve had has been on time and has been kind and helpful”. Another person told us, “They’re brilliant. I can’t fault them”. People told us they were supported by kind and caring staff.

There were robust recruitment procedures in place and staff were supported to deliver the care and support required to meet people’s needs. Staff received essential and additional training and were encouraged to gain further relevant qualifications. Staff completed an induction programme which included shadowing other staff to learn about their role. Their practice was observed to ensure that they were competent to be able to deliver the care people required.

Staff felt supported by the management team and were positive and enthusiastic about their roles. One staff member told us, “I would definitely recommend it to my own family”. There were enough qualified and experienced staff to meet people’s needs.

The provider had good systems in place to keep people safe. Safety risks were identified, assessed and reviewed. There were instructions for staff on what action to take in order to reduce risks identified. Staff received safeguarding training and were able to tell us actions they would take if they had concerns people were at risk of abuse. We saw that where concerns had been identified the provider took the required action.

People told us they were involved in the planning and review of their care. Where people were unable to do this, staff considered the person’s capacity under the Mental Capacity Act 2005 (MCA). Staff observed the key principles of the MCA in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

Prior to our inspection the provider informed us that there had been six medicine errors in the last 12 months. We looked at how the provider managed people’s medicines so that they received them safely. The provider had taken action where medicine errors had been identified and put systems and processes in place in order to reduce the risk of further errors.

If needed, people were supported to eat and drink and maintain a healthy diet.

The service provided was flexible and responsive to people’s needs. People were involved in the initial assessment of their needs and in the planning and review of the care plan which identified what and how care should be provided. People told us that the service was flexible and promoted people’s independence. One relative told us, “They work with him on what he needs on any given day”.

There were quality assurance procedures in place and the provider sought feedback through questionnaires from people, relatives and professionals. People knew how to make complaints and action was taken to resolve any concerns. The provider took steps to ensure that care and support was provided in an appropriate way and, where necessary improvements were made.

On the day of our visit PRN Homecare - Bognor Regis was providing personal care for 130 people in their own homes. We met with the manager and reviewed the service's records and five people's care records. We followed this by telephoning 16 service users and six relatives of service users where we discussed their experiences of the service. We also spoke with three members of staff.

People and their relatives were all complimentary about the service that they received from the agency. One person told us, "The carers are very nice, kind and capable.” A relative told us that the carers were always kind to their relative; they said “They are kind and never patronising. They are friendly and cheer (person sing the service) up.”

We found that people had planned care that met their needs. We also found that people’s consent had been obtained prior to treatment where appropriate.

We found that enough staff worked for the service to meet with the requirements of people that used the service. We also saw that staff had been trained appropriately and took infection control seriously.

We found that the service had systems in place to monitor the quality of the service that they were providing.

People expressed satisfaction with the agency and care workers who visited them. They said that care workers treated them with respect and that they felt safe with the care and support they received.

Everyone said that they had been given a copy of their care plan. Some people said that they had regular contact with the agency to review their care and that they had completed questionnaires about the quality of service provided.

Most people said that care workers arrived on time for visits. One person said, “On very rare occasions staff can turn up late however we always get a call to warn us of this”.

All of people told us that they received the same staff on a regular basis and that this had helped them to build up a relationship of trust with their care workers.

Everyone we spoke with said that care workers were friendly and helpful.

People told us that they had been consulted about the times of their visits.