About the service: Springfield Healthcare (Newcastle) provides personal care to adults with a range of health issues in their own homes. At the time of the inspection 60 people were supported with an average of 1750 hours of care delivered per week.

People’s experience of using this service: People felt safe with care staff visiting them and staff knew how to report any concerns. Risks had been assessed to minimise the potential of harm to people.

People were supported by staff who encouraged their independence and treated them with kindness and compassion. People told us staff were kind, caring and patient when supporting them.

People were fully involved and supported to have maximum choice and control of their lives and were supported in the least restrictive way possible.

People said they received effective health care with positive outcomes. They said staff at the service liaised with other healthcare professionals to ensure their health needs were met. We saw evidence of multi-agency working to meet people's health care needs and appropriate referrals made when necessary.

The registered manager had taken prompt and appropriate action to learn lessons when things went wrong, including a review of the information kept about people who used the service when needed.

Medicines were administered safely.

There were enough staff to provide care calls to people. A small number of people commented that rotas had not always been sent recently and calls had sometimes been either earlier or later than expected. The registered manager was aware of this and new systems and newly employed office staff were now in place to address this.

Staff had taken a range of training, and refresher training was planned. Staff received supervision and an annual appraisal, although this was a little behind. Staff were able to speak with the management team at any time via a range of methods.

The registered manager carried out regular audits of the service to monitor the quality of care provided. Issues identified during the audits were acted on swiftly and lessons learnt to minimise the risk of repeat incidents.

We recognised the improvements the management team had made since our last inspection and the service is now rated overall as good.

For more details, please see the full report below and also on the CQC website at www.cqc.org.uk

Rating at last inspection: Requires Improvement (Report published on 25 April 2018).

Why we inspected: The inspection was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

This inspection took place on 12, 19 and 21 February 2018 and was announced. This was the first inspection of the service since the registration changed in December 2016.

This service is a domiciliary care agency based in Newcastle. It provides personal care and other additional support to people living in their own homes throughout Newcastle and North Tyneside. Services were provided to adults with a wide range of health and social care needs including physical disabilities, sensory impairments, learning disabilities, mental health needs and people living with dementia. At the time of our inspection there were 104 people receiving a service.

Not everyone using Positive Life Choices (Newcastle) receives regulated activity; The Care Quality Commission (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.

The service had a registered manager in post. The registered manager has been in post since the service registered on 9 December 2016. A registered manager is a person who has registered with the CQC 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.

Medicine management had some areas to improve upon, including ensuring the full completion of medicine administration records and ensuring that any support given by others was correctly recorded and monitored. The provider needs to ensure guidance in the National Institute for Health and Care Excellence (NICE) guidelines if followed by all staff.

Risk assessment were not always in place, fully completed or regularly reviewed for people. This included, for example, people who were at risk of having an epileptic seizure or those at risk from diabetes. This meant people were not always protected from harm as much as they could have been because staff did not always have the written guidance to keep people safe. Accidents and incidents were recorded and monitored for trends and any learning was discussed through meetings and quality monitoring procedures. Emergency plans were in place should an unpredicted event occur, for example, very poor weather conditions.

There were enough staff employed at the service, however further improvement needed to be made on rostering systems and continuity of staff to fully meet the needs of people who used the service. People and relatives told us that they had, on occasions, too many different staff attending to their needs and that rota’s changed with little or no notice. We also saw evidence of positive responses taken by the provider to change people’s care calls when asked, because of hospital appointments or days out.

A continuous programme of staff recruitment was in place to maintain and grow numbers of care staff. Induction, training and continuous support procedures were in place and people thought staff were well trained to help them, but a small number felt they needed to remind some staff regarding moving and handling instructions. New Care Coaches were in place who gave additional support to newly appointed care staff. We found some gaps in areas of support, for example supervision and appraisal procedures, however, staff still felt supported.

The provider monitored missed calls, however was not able to do this robustly as they relied on staff reporting missed calls or the people themselves ringing in to report this to the office.

People felt safe with staff who visited them at home. We observed staff who knew people’s needs well. One person said, “Safe as I can be, yes.” People and their relatives told us that staff listened to them, were caring and often went the ‘extra mile’. Staff were respectful of people and treated them as individuals. The provider had organi