Direct Personnel Agency Limited provides personal care, including specialist palliative care, to people living in their own home.

We inspected the service on 22 May 2017. The inspection was announced. At the time of our inspection 28 people were receiving a personal care service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers (the ‘provider’) 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.

Following our last inspection in January 2015 we rated the service as Good. At this inspection we were pleased to find service quality had been maintained and the rating remains as Good.

Everyone we spoke with told us that they were highly satisfied with every aspect of the service they received. In particular, the provider’s careful approach to managing staffing resources which meant staff were rarely late for the start of their care calls. Staff had established warm, friendly relationships with people and went out of their way to help them in any way they could. Staff worked together in a supportive way and participated in a varied programme of training appropriate to their needs. They were proud to work for the provider and felt listened to by the registered manager and other senior staff.

People were involved in agreeing the type and amount of care they received and their needs and wishes were understood and followed by staff. Staff treated people with dignity and respect and encouraged them to maintain their independence. Staff had the knowledge and skills required to meet people’s individual needs effectively and supported them to prepare food and drink of their choice.

People’s medicines were managed safely and staff worked closely with local healthcare services to support people to access any specialist support they needed. The provider assessed any potential risks to people’s safety and welfare and put preventive measures in place where required. Staff knew how to recognise and report any concerns to keep people safe from harm.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. Staff understood the principles of the MCA and how to support people who lacked the capacity to make some decisions for themselves.

The provider was committed to the continuous improvement of the service and maintained a range of systems to monitor service quality. The provider sought people’s opinions through regular customer surveys and people were confident any complaints would be handled properly.

We undertook an announced inspection of Direct Personnel Agency on 27 January 2015. We told the provider two days before our visit that we would be coming.

At our last inspection in April 2013 the service was meeting the regulations inspected.

Direct Personnel Agency provides personal care services to people in their own homes. The service also provides care and support to people during the night who are nearing the end of their life. At the time of our inspection, 30 people were receiving a personal care service.

There was 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.

People were kept safe and free from harm. There were appropriate numbers of care staff employed to meet people’s needs and provide a flexible service.

Care staff were able to accommodate last minute changes to appointments as requested by the person who used the service or their relatives.

Care staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Care staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care.

People were supported to eat and drink. Care staff liaised with people’s GP and other healthcare professionals as required.

People and their relatives were able to raise any issues or concerns and action was taken to address them.

The registered manager was accessible and approachable. Care staff, people who used the service and relatives felt able to speak with the registered manager and provide feedback on the service.

The registered manager undertook checks to review the quality of the service provided.

We conducted an unannounced visit to Direct Personnel Agency on 29 August 2012. We did not gather enough information at our visit to enable us to make a judgement about the care they provide. We wrote to the provider requesting further evidence be submitted to us by 21 September 2012. This was received.

Direct Personnel Agency provides care to people in their own home. The majority of the care is short term end of life care. During our visit we spoke with the registered manager of the service and telephoned two care workers and two relatives of people who use the service. We also spoke with the Primary Care Trust who commission the service.

People we spoke with told us they were happy with the care they received. One person we spoke with told us, “We’ve some jolly good ladies here, I honestly can’t complain at all.” Another person told us, “They are very good and turn up on time.”

We saw the care plans did not fully describe the care people needed. Risk assessments were not detailed enough to ensure the care people received was safe.

Records showed recruitment processes described in the provider’s policy had not been followed. The manager was unaware of the need to refer staff who were thought to be no longer fit to work in adult social care to the appropriate bodies.

Direct Personnel Agency provides care to people in their own home. We visited their offices to look at paperwork. We spoke to two people who’s relatives received care from Direct Personnel Agency and three members of staff who worked for the agency, over the telephone.

People told us they were happy with the care they received. One relative told us, “They are very helpful.” Another relative said, “I think they are wonderful I would be devastated if they were not there.” Relatives we spoke with told us they had regular carers, this enabled them to build a relationship and develop Trust with the care workers. People told us carer workers turned up on time.

Care workers assisted people with their medication. Where people were not able to self medicate, care workers involved family members and other health care professionals to ensure medication was administered at the appropriate time.

Appropriate checks were carried out on staff before they were allowed to work with vulnerable people.

The provider had systems in place to ensure people were happy with the care they received.

People’s records were kept securely and could be located promptly when needed.