The inspection of Heritage Healthcare – Wakefield took place between 14 and 17 August 2018, and 24 August 2018. The inspection was announced on each day and consisted of a mixture of site visits and telephone calls to people who use the service and staff. This was the first inspection of this service.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. Not everyone using Heritage Healthcare – Wakefield receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. There were 25 people using the service at the time of the inspection, 17 of whom received support with a regulated activity.

There was a registered manager in post but they were on annual leave at the time of the site visits so we spoke with them by telephone on 24 August 2018. 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 relatives we spoke with were happy with the support they received and told us they felt safe with staff. This was because staff were confident and well trained, always willing to work with the person and ensure their needs were met as they preferred them to be. Staff were able to explain how they would recognise and respond to any concerns promptly and we heard this happen during our site visit.

Risks were managed with the person at the centre and measures to reduce the likelihood of harm were understood and followed by staff. Risk assessments and care plans were detailed and provided staff with the relevant guidance.

We found people received calls at the time and for the duration they requested, and staff had sufficient time to complete tasks. The electronic system used by the service provided real time data which was overseen by the registered manager and provider to ensure swift action was taken if alerts were received.

Medication administration and infection control practices were safe and followed required guidelines.

The registered manager displayed a thorough knowledge of their role and how to access current best practice information. They discussed many topics in depth showing an appreciation of the challenges of care delivery whilst keeping the person at the centre. Their focus and drive was evident and embodied in the culture of the service by the many positive comments received by people using the service and staff.

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 were supported to access other services as required and staff were encouraged to ask for training in specific conditions which was duly arranged. Effective nutritional monitoring was in place.

People and relatives spoke extremely highly of all care staff and were very complimentary about their approach and willingness to assist. People’s preferences and views were integral to care delivery including timing of calls and type and manner of support received. Records showed people were at the heart of the process.

Dignity and privacy was promoted at every opportunity and all staff placed a strong focus on this aspect of care delivery.

Care records contained detailed, person-specific information to guide and support staff so care was delivered in line with people’s wishes and preferences as far as possible. Staff spoke positively about the electronic system, saying how easy and reliable it was, providing current informat