This inspection took place between 20 and 29 November 2018. The inspection involved visits to the agency's office, to people’s own homes, conversations with people, their relatives, staff and professionals. The agency was given two working days’ notice of the inspection. The agency provided 70 to 80 people with a domiciliary service, for approximately 750 hours a week. Many of the people were older persons, some people also lived with long-term medical conditions and some had alcohol or substance abuse related conditions. People received a range of different support in their own homes. Some people received occasional visits, for example weekly support to enable them to have a bath. Other people needed more frequent visits, including visits several times a day to support them. This could include two care workers and the use of equipment to support their mobility. Some people needed support with medicines and meals preparation.

The service had 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. The provider for the agency is Apex Primecare Limited, a national provider of care.

This was the service’s first inspection under Apex Primecare Limited. Services were provided to people who lived in Brighton and Hove and local areas as far as Worthing and Saltdean.

People were safeguarded against risk, including risk of abuse. The registered manager and care co-ordinators ensured a full assessment of people’s needs took place before they agreed to provide them with a service. People had relevant risk assessments completed. Where risk was identified care plans, which were regularly reviewed, were put in place to reduce risk. Staff were knowledgeable about how to ensure people’s safety, including safety from risk of abuse. Where people used equipment, staff used it safely to support them.

Where people needed support with medicines, this was done in a safe way. The registered manager reviewed medicines management regularly and developed action plans if issues were identified. Where people needed support to eat and drink, people had care plans, which staff followed, so their needs were met.

Staff understood the principals of prevention of risk of infection. Staff said they had ample supplies of items such as disposable gloves. We saw staff followed the provider’s policies and procedures when they were with people in their own homes.

There were enough staff to ensure people did not experience missed or shortened visits. Staff had been recruited in a safe way to ensure new members of staff were safe to support people.

Staff were supported by the agency so they had the skills they needed to meet their individual needs. This was through the provider’s ongoing induction and training programmes. The performance of staff was also regularly monitored, including when they worked with people in their own homes.

People were supported with accessing relevant external professionals, including their GPs and district nurses. External professionals told us the agency communicated well with them and responded appropriately to their directions.

Staff understood the importance of gaining people’s consent to care. Where relevant, people had mental capacity assessments completed, and best interests meetings were recorded.

People commented on the kindness, compassion and respect they received from staff. They also said staff encouraged them in remaining as independent as they wished to be. Staff supported people’s relatives in a kindly and supportive way. Staff clearly knew people as individuals, taking their preferences into account when providing care.

People told us they received a responsive service from staff, who knew them well.