This inspection took place on 25, 29 and 31January 2018 and was announced. This service is a domiciliary care agency based in Newcastle upon Tyne. It provides personal care to people living in their own homes in 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 dementia. At the time of our inspection there were approximately 275 people receiving a service.

Not everyone using St Anthony of Padua Care Services (known locally as St Anthony's) 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.

Our last inspection of the service was carried out in November 2015 and we rated the service as ‘Good’. At this inspection we found that the service had improved further and was ‘Outstanding’.

The service had a well-established registered manager in post who had been registered with the CQC since February 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.

Staff told us that the Chief Executive Officer (CEO) for the provider organisation was an exceptional leader and that the service has become much better since their appointment over two years ago. We saw the service had significantly developed the quality assurance processes and improved their engagement with people who used the service for example. We found the CEO had a clear vision for the service which put people at the heart of it.

Both the CEO and registered manager had extensive employment histories supporting vulnerable people who require personal care and assistance. The service benefitted from a reliable and steady team of devoted staff who told us they were proud to work for the provider and loved their jobs.

The service was based in the heart of the community it served where people and staff were welcomed into the office and community day centre. As the provider was a charitable organisation they were especially keen to make strong links with the community and neighbouring services. We saw a host of successful collaborations had been made with other local businesses which helped local people including those who used the provider's care at home service. The provider used a wide range of methods to engage with people and empowered them to voice their opinions. A recent ‘service user’ survey had been carried out in October 2017 which was positive.

There was a strong quality assurance framework in place across the service to ensure that the monitoring of the service was methodical, meaningful and in-depth. Audits carried out by the management team and provider’s board of trustees demonstrated that checks on the service were systematically undertaken and where issues were identified, action was taken. The senior management team and board of trustees had oversight of all matters arising to make sure these had been effectively and correctly dealt with in line with the provider’s policies and principles. A detailed action plan for continuous improvement had been drafted and was used to direct the management team and support them to focus on the provider’s key priorities.

The service had an excellent person-centred culture. The management team and staff were extremely committed to delivering a service which was exceptionally caring and empathetic. People and relatives overwhelmingly expressed their satisfaction about the service and told us their care workers provided first class sensitive and compassionate support and they respecte

We found that people who used the service made decisions about, and had agreed to, the care they received.

People’s care and support was planned to meet their individual needs and protect their personal safety.

There were suitable arrangements in place to make sure people were given their prescribed medicines in a safe way.

Most people using the service and their representatives described their care service as excellent or good. Their comments included, “They see to my mother's needs. I have no complaints about their work”; “The care workers do a great job and I like them because they do everything when I ask them, that is, if the same carers come”; and, “They all come across very professional and deliver a kind and caring service”.

The service had enough experienced and skilled staff to provide people with reliable and consistent care.

There was a clear complaints process that people were made aware of and any concerns raised were responded to appropriately.

People using the service and their relatives told us they received reliable services that met their care needs. They spoke highly of the care workers and the quality of the support they provided. Their comments included: “The service is very person focused”; “Workers are genuinely caring and really friendly”; “They do a good job and always check if I want them to do anything else”; and, “I’d recommend them to anyone”.

We carried out an inspection of St Anthony of Padua Care Services on 20 and 25 November 2015. The inspection was announced. This was to ensure there would be someone present to assist us. We last inspected St Anthony of Padua Care Services in November 2013 and found the service was meeting the legal requirements in force at that time.

St Anthony of Padua Care Services is a domiciliary care agency that provides care and support to people in their own homes. Personal care is also offered to people in supported tenancies in Assisi House; also developed by St Anthony of Padua Community Association. The Association is a charity based within the East End of Newcastle. At the time of the inspection there were 288 people in receipt of a service. Personal care was provided to people in the East side of Newcastle either by contract with the local authority or private arrangement.

The service did not have a registered manager in post, however the manager had applied to be registered as a fit and proper person. 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.

People told us they felt safe and were well cared for. Staff knew about safeguarding vulnerable adults. The nine alerts we received during the past year had been dealt with appropriately, which helped to keep people safe.

We were told staff provided care safely and we found staff were subject to robust recruitment checks. Arrangements for managing people’s medicines were also safe.

Staff obtained people’s consent before providing care. Arrangements were in place to assess people’s mental capacity and to identify if decisions needed to be taken on behalf of a person in their best interests.

Staff had completed relevant training for their role and they were well supported by the management team. Training included care and safety related topics and further topics were planned.

Staff were aware of people’s nutritional needs and made sure they were supported with meal preparation and food shopping where necessary. People’s health needs were identified and where appropriate staff worked with other professionals to ensure these were addressed.

People had opportunities to participate in activities and in accessing their local communities. People and their relatives spoke of staffs kind and caring approach. Staff explained clearly how people’s privacy and dignity were maintained.

Staff understood the needs of people and we saw care assessments were received from the local authority before packages of care were developed. Staff developed care plans with sufficient detail to guide care practice. They were person centred. People’s and their relatives spoke highly about the care provided.

People’s views were sought and acted upon, through annual surveys, care review arrangements and the complaints process.

People receiving a service and staff expressed confidence in the manager, supervisory staff and the executive team. They felt there was good leadership and there was a clear, values based ethos underpinning the service. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care. Senior managers were observed to act as excellent role model’s, actively seeking and acting on the views of others. They were actively implementing plans to improve engagement with people using the service and enhance staffs working terms and conditions.