About the service: Progress House is registered to provide personal care and support to people living in their own homes or in supported living accommodation. At the time of our inspection Progress House was providing support to 85 people.

People’s experience of using this service:

¿ People told us that care staff were kind and caring in their interactions with them. People told us that staff knew their needs well, and were reliable. Some people told us their calls were sometimes late, but they could rely on staff attending at each planned visit.

¿ People were not always protected against the risks associated with the unsafe management and handling of medicines. Documentation was poorly completed.

¿ Auditing processes had failed to identify issues with medicines documentation and administration which put people at risk of harm.

¿ Late visits were not being monitored by the management team to ensure that care was carried out in a timely manner.

¿ Further improvements were needed to ensure care plans and risk assessments were accurate and sufficiently detailed.

¿ There were sufficient staff to cover all visits. Recruitment procedures were in place to ensure staff were suitable for their roles.

¿ The principles of the Mental Capacity Act (2005) were adhered to.

¿ People were supported to eat and drink enough to maintain a balanced diet.

¿ People had access to healthcare professionals when required.

¿ Staff knew how to care for people and received training in their roles, and support from the registered manager.

¿ The registered manager was open and transparent and welcomed feedback from us. They demonstrated a commitment to putting systems in place which would promptly address the issues we found.

¿ We found the service had deteriorated and met the characteristics of a ‘Requires Improvement’ rating in safe, responsive and well-led. This meant the overall rating was ‘Requires Improvement.’

Rating at last inspection: At the last inspection the service was rated Good (Report published June 2016).

Why we inspected: We inspected this service in line with our inspection schedule for services currently rated as Good.

Enforcement: Action we told the provider to take is outlined at the back of the report.

Follow up: We will continue to monitor this service according to our inspection schedule in line with the rating of ‘Requires Improvement.’

We inspected Progress House on 2 March 2016. The inspection was announced because we wanted to ensure that there would be someone present when we visited and that the service had time to arrange a list of people we could speak to.

Progress House is registered to provide personal care and support to people living in their own homes. At the time of our inspection Progress House was providing support to 80 people.

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. We were told that the manager was new to the post and was in the process of submitting their registration documents.

Staff knew how to recognise and report any concerns so that people were kept safe from the risk of abuse. People who needed support were assisted to safely use medicines. There were enough staff to enable all of the planned visits to be completed on time. Background checks had been completed before new staff had been appointed.

Staff knew how to care for people in order to meet their needs and they had received all of the training and support they needed. People had been supported to eat and drink enough and to access any healthcare services they needed.

The registered manager and staff were following the Mental Capacity Act 2005 (MCA). This law is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.

People and their relatives said that staff were kind and caring. Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had been consulted about the care they wanted to receive There were arrangements in place to quickly and fairly resolve complaints.

Regular quality checks had been completed and people had been consulted about the development of the service. The service was run in an open and relaxed way, there was good team work and staff were supported to speak out if they had any concerns about poor practice. People had benefited from staff acting upon good practice guidance.

We visited three people in their homes and also spoke with 20 people by telephone. Generally people were pleased with the quality of the service that they received. One person told us, “They do a really good job under sometimes difficult circumstances. They strive to get it right, and do so 99.9% of the time." Our inspection confirmed that care and support was planned and delivered in a way that was intended to ensure people's safety and welfare.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and assistance safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people received. Appropriate systems were in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and of care staff.

There was a generally effective complaints system available with comments and complaints people made being responded to appropriately. However some people who we talked with said that they had complained, without success, about visits being late and about not being notified about changes to the care staff visiting them.

We spoke with five people who used the service. They were all complimentary about the service saying it was, "Really good" and "I cannot complain about anything."

People we spoke with felt involved in planning their care package. The manager visited people in their home to carry out an assessment of their needs before care was provided.

We looked at six care plans. We saw that these were fully completed and contained personal details, care assessments, risk assessments, care plans and care worker visit reports. The care needs of the individual were clearly identified in the care plan.

The service carried out robust quality assurance checks and used these to monitor and improve the service provided