This inspection took place on 10, 12 and 20 December 2018 and was announced. The inspection was announced to ensure that the registered manager or appropriate person would be available to assist with the inspection.

City Care is a domiciliary care agency. It provides personal care and support to people living in their own homes. At the time of inspection there were 110 people receiving the regulated activity of personal care.

At the last inspection the service was rated good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained good.

The service had two registered managers. A registered manager is a person who has registered with the Care Quality Commission (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.

One registered manager was currently on maternity leave and we were informed that the second registered manager had resigned from their position unexpectedly on 7 December 2018. The directors supported us on our inspection. One of the directors was previously a registered manager and had started their application to become the registered manager for the service.

A robust recruitment process was in place ensuring staff had the appropriate skills, experience and knowledge to care for and support people. The service ensured that people received support from the same regular team of staff. Environmental and individual risks were identified and mitigated against.

People received support with their medication as prescribed. Staff sought permission before supporting people and promoted their independence. People were supported to access health professionals when required.

Staff we spoke with were complimentary about the training and support they received. Training, supervisions and appraisals were up to date and monitored.

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 and their relatives told us staff members were kind and caring. Care staff were responsive and alerted supervisors to changes in people’s care needs. This information was swiftly incorporated into people’s care plans.

The provider had systems to review aspects of the running of the service. The registered manager had ensured statutory notifications had been completed and sent to the CQC in accordance with legal requirements.

The service had an effective complaint process in place. People and relatives we spoke with told us they did not have any complaints. The provider regularly sought feedback about the service from people, relatives and staff.

Further information is in the detailed finding below.

The inspection took place on 17 and 20 June 2016. This was an announced inspection. We last inspected the service in June 2014 and found the service met the regulations we inspected against at the time.

City Care is a domiciliary care agency which provides personal care and support to people in their own homes who have a variety of needs. The service is managed from an office located in Sunderland. At the time of this inspection 130 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 using the service told us they felt safe when regular staff supported them. Some people had regular teams of care staff. This made them feel confident in the staff that supported them. Other people said they did not know which care staff would visit them and were not always told if they were going to be late.

Some people told us staff rotas sometimes created difficulties, for example when calls overlapped and people didn’t receive the full amount of allocated time. One person said, “Sometimes they can be in a bit of a hurry.” Other people told us rotas were fine and they received their allotted time. One person said, “They take their time. They don’t rush and they take their time to get me to bed.”

Most people and relatives we spoke with felt there were enough staff to carry out visits, and spoke positively about the service. One person said, “I have good carers. I get on with everybody, nothing is a bother.” Another person told us, “I’ve never had a person who I haven’t got on with. They are friends which is a great thing."

Staff received training in safeguarding vulnerable adults, and told us about their obligations should any concerns arise. Staff said they felt any concerns they had would be taken seriously. Safeguarding concerns, accidents and incidents were recorded and dealt with appropriately. They were also analysed so lessons could be learnt to prevent recurrence.

Staff had the knowledge and skills they needed to carry out their roles and responsibilities, so people received effective care. Staff completed an induction programme before providing care, and completed additional training at regular intervals.

Staff received supervisions and observations every three months and an annual appraisal which incorporated a personal development plan. Notes of supervisions contained good detail around what staff enjoyed about their job, feedback from managers and feedback from people who used the service.

People and relatives told us staff were caring and listened to what people wanted and needed. People said they had positive relationships with care staff. One person said, “They couldn’t be more helpful if they tried.” Another person told us, “The staff look after me well and we get on. Staff take me shopping and out for lunch. I like all the staff.”

Staff had access to clear guidance about how to provide care and support to people, according to their individual needs and wishes. This guidance was set out in people’s care plans which were reviewed and updated when people’s needs changed.

Each person had a service user guide which contained the provider’s statement of purpose and complaints policy in their care plan, which was kept in their home.

People’s views about the service were sought by senior managers via telephone calls every three months. Comments from recent telephone feedback included, ‘I’m happy with the service provided,’ ‘I’m happy with all the staff who look after me’ and ‘It has not been necessary to complain in five years.’

The provider ensured the quality of the service was assessed and monitored by carrying out regular audits of all aspects of the care provid

People using the service made positive comments about the care they received from staff at City Care. One person told us the staff were “Very pleasant and helpful.” Another person told us “I can’t fault them.”

We found that people received the care and support that they needed and the service provided safe and appropriate care because individual needs were established before people started using the service. One person told us “Everything was agreed with us.”

The manager had systems in place to regularly check the quality of the care and people’s comments and complaints were listened to and acted on effectively.

Staff were fully supported to meet people’s needs because they received regular supervision sessions and training. One person told us “I couldn’t wish for better people to be looking after me.”

We, the Care Quality Commission, have completed two inspections at City Care Domiciliary Care Agency. The first review was completed on 30 April 2012, and we found that improvements were needed. The visit for the second review was completed 25 August 2012 and this report describes our findings.

We did not discuss the outcome we were reviewing with the people who use the service.

People we spoke with who use the service spoke positively about the service. Comments we received included “my carers are a lovely bunch”, “I wouldn’t be here without them” and “I have the same team coming to see me and they know me really well”.