We inspected Careline Homecare (Middlesbrough) on 21, 28 and 29 June 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in to assist us. Careline Homecare (Middlesbrough) is an established service which had previously registered at a different location. This is a first inspection of a newly registered service. At this inspection we rated the service as Good.

The service is registered to provide personal care to people living in their own homes. The service can provide care and support to older people, people with mental health conditions, people with a learning disability, physical disability or those people who are at end of life. Careline Homecare (Middlesbrough) also provides a rapid response service. The aim of the rapid response is to provide care and support to people in their own homes whose informal care and support package has broken down unexpectedly and who may have had to go into a hospital or care home because they were unable to manage at home. This service is also provided to people who are discharged from hospital. Healthcare professionals contact the service when a person is identified as needing rapid response. Staff at the service respond by visiting the person at home within two hours of the initial call. This service is provided to people for up to 10 days and then the person is reassessed and their on-going needs determined. At the time of the inspection 240 people were using the service.

The service had a registered manager. 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 the service kept them safe. Risks to people were assessed and plans put in place to reduce the chances of them occurring. Policies and procedures were in place to safeguard people from abuse. People’s medicines were managed safely. The provider and manager monitored staffing levels to ensure enough staff were deployed to support people safely. The provider’s recruitment process minimised the risk of unsuitable staff being employed.

People told us staff had the skills needed to support them effectively. Staff were supported with regular training, supervision and appraisal. People’s rights under the Mental Capacity Act 2005 were protected. 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. Some people received support with their food and nutrition. Where this was the case their nutritional needs and preferences were recorded in their care records. The service worked with external professionals to maintain and promote people's health and wellbeing.

People and their relatives spoke positively about the care they received, describing it as kind and caring. People and their relatives told us staff treated people with dignity and respect. Staff helped people to maintain their independence. Policies and procedures were in place to arrange advocates for people should this be needed.

People told us they received personalised care based on their assessed needs and preferences. Care plans were reviewed regularly to ensure they reflected people’s current support needs and preferences. Procedures were in place to investigate and respond to complaints.

Staff spoke positively about the culture and values of the service and also spoke positively about the manager. People said the registered manager was available to speak with if they wished to raise any concerns or feedback. The manager and provider carried out a number of quality assurance checks to monitor and improve standards