The inspection took place on 6 January 2017 and was announced. We gave the registered provider 24 hours’ notice of the inspection because it is a community based service and we needed to be sure the office would be staffed.

Care at Home (Wearside) Limited is a domiciliary care service that provides personal care to people in their own homes. This includes care and support for people living with dementia. At the time of the inspection the service provided personal care services to 125 people.

The service had a registered manager in post at the time of inspection. 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 and their relatives told us they felt the service was safe. People had appropriate risk assessments in place and associated care plans.

The registered manager and staff were confident in their roles to safeguard people from abuse. Records showed staff members had alerted senior staff to situations where they felt people may have been at risk of or were being subjected to abuse. Safeguarding concerns were raised with the local authority in a timely way. Subsequent actions were taken from safeguarding concerns raised.

The registered manager understood the principles of Mental Capacity Act 2005 and had made referrals to the local authority requesting assessments and best interest decisions for people she felt were potentially vulnerable and lacked capacity to make specific decisions. The majority of staff had received up to date training in MCA and a plan was in place for the remaining staff. Members of staff we spoke with understood the importance of seeking consent from people prior to providing support.

Staff received regular supervisions and annual appraisals. Staff had up to date training with an ongoing plan to ensure training remained up to date.

People were supported to meet their nutritional needs. We saw people had eating and drinking risk assessments in place and people told us staff supported them by making meals and drinks. People had also been referred to the speech and language therapy team (SALT) for an assessment when required.

People told us staff were caring, lovely people. They were supported to be independent wherever possible and were supported to access the local community when receiving companionship as part of their personal care.

People had access to advocates where required. During the inspection we found one person was receiving advocacy support. The registered manager informed us that if a person lived alone and had no relatives, they would support them to access a suitable advocate through the local authority.

People’s care plans did not always contain sufficient information to guide staff in how to provide support to people safely. The majority of care plans were not personalised and did not contain people's personal preferences. The registered manager explained that a transition process was underway for all care plans to be transferred to a new, comprehensive template. We viewed some care plans that had completed this transition and found them to contain detailed guidance for staff including people’s personal preferences.

People and their relatives knew how to complain and felt confident and able to do so. People spoke positively about the service and told us they had nothing to complain about. One person did tell us about a previous complaint they had which the registered manager resolved and they were happy with the outcome. We saw from records that complaints received were investigated and acted upon with outcomes fed back to complainants.

Care and senior staff meetings were held regularly to discuss service provision and ideas to improve quality. Newsletters were also sent to all staff m