This inspection took place on 8 October and 9 November 2018. The provider was given 24 hours' notice to make sure someone would be at the registered office to meet us.

This service is a domiciliary care agency. It provides personal care to people living in their own houses. It provides a service to older adults, younger adults and children. The service covers a large area which includes County Durham, Gateshead and South Tyneside and is managed from an office located in Consett. At the time of this inspection 336 people were using the service.

Not everyone using Kelly Park Limited received 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 consider any wider social care provided.

We last inspected this service in August and September 2017 when it was rated ‘requires improvement’. At the last inspection we made two recommendations. These were that the provider reviews staffing levels and does an in-depth analysis of call times once the electronic monitoring system is embedded and that the provider reviews the competency of all staff in relation to moving and positioning so that they can be confident staff have the necessary skills to support people safely.

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.

Some people and relatives told us that their care workers were not always consistent or arrived as expected. Documentation confirmed that some people’s care was completed either early or late and care workers did not always stay for as long as was agreed.

Staff supported people to stay safe in their own home. Assessments of risks people faced were in place for care workers to follow. These were regularly updated to reflect any changes in people's care needs.

Staff understood their responsibilities with regards to protecting people from harm. Safeguarding incidents had been responded to in-line with the service’s procedures. Staff recruitment was safe.

Medicines were well managed. Medicine administration records were completed accurately. Competency checks were conducted with care workers to ensure they remained competent with this task. The company provided care workers with personal protective equipment (PPE) and reminded staff to use this appropriately.

Staff completed an induction programme before providing care and completed additional training at regular intervals. Induction training included training to meet the needs of people using the service but some of this was not routinely updated. Staff received regular supervisions, observations and an annual appraisal. We made a recommendation that specialist training be reviewed and updated periodically to ensure staff have up to date knowledge and skills in these areas.

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 told us that care workers made meals of their choice and supported them appropriately with eating and drinking. External health and social care professionals were involved with people's care to ensure their ongoing welfare.

People, relatives and professionals told us all staff were caring, kind and respectful. People said care workers upheld their dignity and privacy. Care plans contained person-centred information.

People's needs were assessed, planned and reviewed to ensure they received care which met their needs. Care plans reflected people’s social needs and the service supported these needs where commissioned to do so.

Complaints

This inspection took place on 30 August, 1, 4 and 7 September 2017. The provider was given 24 hours' notice to make sure someone would be at the registered office to meet us. We last inspected this service in November 2015 when it was rated good.

Kelly Park Limited 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 covers a large area which includes County Durham, Gateshead and South Tyneside. The service is managed from an office located in Consett. At the time of this inspection 395 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.

During this inspection 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 and gave them continuity of care. 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 were scheduled 'back to back' and people didn't always receive the full amount of allocated time. People had mixed views about the punctuality of staff.

We have made a recommendation that the provider reviews staffing levels and does an in depth analysis of call times once the electronic monitoring system is embedded. We have made a recommendation that the provider reviews the competency of all staff in relation to moving and positioning so that they can be confident staff have the necessary skills to support people safely.

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.

Staff completed an induction programme before providing care, and completed additional training at regular intervals. Staff received regular supervisions, observations and an annual appraisal, although records of these lacked meaningful detail.

Medicines were mostly managed safely but we found some gaps in electronic records due to teething problems with handheld devices, most of which the provider had already identified and addressed.

Most people and relatives we spoke with said they felt staff had the right skills and training to provide care and support, although six people we spoke with felt staff training could be improved.

Most people and relatives told us staff were caring and listened to what people wanted and needed. Most people said they had positive relationships with care staff. People said staff promoted their independence and treated them with dignity and respect.

Some care plans lacked personal information about how people needed and wanted to be supported.

People told us they knew how to make a complaint. People and relatives had mixed views on how appropriately their complaint had been handled.

People and relatives had mixed views on whether the service was well-led. A number of people we spoke with felt improvements were needed in relation to receiving information about which care workers would visit their homes in advance, staff arriving too early or too late and the service not communicating when workers were late.

Staff spoke positively about the manager being approachable and supportive.

The provider had a quality assurance system in place but this had not always been effective in monitoring staff punctuality in relation to people's scheduled care visits.