Direct Health is a domiciliary care agency. It is registered to provide personal care to people living in their own houses and flats in the community. The services office is based in the S9 area of Sheffield, close to local amenities and transport links.

At the time of this inspection, 523 people were receiving support and 259 care workers were employed.

There was a manager at the service who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

Direct Health is an established care provider and has been operating in Sheffield for many years. The registered provider of the service transferred to Accord Housing Association Limited in April 2017. This is the service’s first inspection under their new registration.

This inspection took place on 23 and 24 April 2018 and we gave the registered provider 48 hours’ notice of our inspection to make sure the registered manager, some staff and some people receiving support would be available to meet and speak with us.

We received mixed views from people about the support provided to them. Some people spoke very positively and told us they felt safe and their care workers were respectful and kind. Some people told us they received a consistent and reliable service that met their needs. Other people had concerns about the times of their visits. A few people told us they had not always found some care workers respectful. We shared specific concerns with the registered manager who took immediate action to resolve these concerns and improve people’s experience.

We found systems were in place to administer people’s medicines safely. The service adhered to the local authority policy for the safe administration of medicines. Systems were monitored and any errors were reported and acted on to prevent reoccurrence.

We found there were systems in place to protect people from the risk of harm. Staff we spoke with were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified risks to people, and these were regularly reviewed to ensure people's safety.

Robust recruitment procedures were in operation and promoted people’s safety.

Staff were provided with relevant training, supervision and appraisal for development and support.

There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice. People had consented to receiving care and support from Direct Health (Sheffield).

People were supported to maintain a healthy diet, which took into account their culture, needs and preferences, so their health was promoted and choices could be respected.

People said they could speak with their care workers or the registered manager if they had any worries or concerns and they would be listened to. Some people said they experienced poor communication from the office staff.

We found a system was in place to monitor service delivery.