About the service: SureCare North Leeds is a care at home service that was providing personal care to 20 older people at the time of the inspection.

People’s experience of using this service: We received positive feedback from people regarding the service they received and the staff who supported them.

The service had made improvements to their care plans since our last inspection and made them more personalised.

Audits and systems were effective at supporting the registered manager to monitor the service and make improvements.

There was a quality assurance system in place and people completed surveys several times a year. The comments made by people were acted on. The service was able to show how they used people’s views to improve the quality of the service.

Risk assessments were in place. Staff knew how to keep people safe and were trained in safeguarding.

People spoke positively about the registered manager and told us they were responsive and approachable.

Robust recruitment and selection procedures ensured suitable staff were employed.

Staff received appropriate training and support to meet people’s individual needs.

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 supported to have enough to eat and drink.

Healthcare professionals were involved in people’s care and support as and when this was needed.

There were systems in place for communicating with staff, people and their relatives to ensure they were fully informed via team meetings, group messages and phone calls.

People were supported to be independent and their rights were respected. Support was provided in a way that put the people and their preferences first. Information was provided for people in the correct format for them.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection: Requires Improvement (report published 6 April 2018)

Why we inspected: This inspection was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor information we receive about the service. If any concerning information is received, we may inspect sooner.

This was an announced inspection carried out on 12 and 24 January 2018.

Surecare North Leeds is a domiciliary care service. The service provides personal care for people living in their own homes. It provides a service to older adults. This was Surecare North Leeds’ first inspection since their registration with the Care Quality Commission (CQC) in January 2017.

At the time of our inspection 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.

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 provided consent to staff to receive care and support with their care needs.

People told us they received their medicines as prescribed. Staff completed training in the safe administration of medicines. However, we found that medicine administration records (MARs) were not always used correctly and were incomplete. Plans describing where topical medicines were to be applied and how people preferred to be given their medicines were not always completed. This was a breach of legal requirements.

Staff identified and managed risks to people's health and well-being. Staff developed risk management plans that contained details of the risks and action staff should take to manage them. However, we found some risk assessments lacked detail and others did not reflect people’s current needs.

People using the service and their relatives were involved in making decisions about the care they received. Assessments included people's care and support needs. Care was not always planned and documented in a way that was person centred and care plans lacked detail about people's likes, dislikes and personal preferences.

The registered provider had quality assurance systems in place. Staff completed regular checks of the quality of care. However, audits had not identified the areas of concern we found during our inspection in relation to medicines management and care records.

Staff were supported by the registered manager and office based staff. Staff received training, supervision and an appraisal. Newly employed staff underwent an induction and worked with experienced staff.

There was enough staff available to meet people's care needs. The staff rota showed when two members of staff were required to safely care for people, because of their specific care needs.

The registered provider's safeguarding policies and processes guided staff to help protect people from abuse. Staff knew the types of abuse and when to raise a safeguarding alert.

The environments where staff would be working had been assessed and staff were aware of infection control measures to reduce the risk of infection. Staff accessed equipment to protect against cross contamination.

The registered manager followed safe recruitment processes. New members of staff had pre-employment checks completed, such as criminal record checks via the Disclosure and Barring Service (DBS) and references from previous employers. This helped to ensure suitable staff were employed.

People's nutritional needs were met by staff. This helped people to maintain their health and wellbeing. People had meals they wanted and in sufficient quantities. Staff supported people with shopping for food items if they wanted to make meals for themselves.

Staff supported people to access healthcare services if they needed such support. Staff followed the guidance of health care professionals to help people maintain their health.

Staff provided care and support to people in a way that showed they respected their dignity and privacy. Staff ha