This inspection took place on 6, 8, 11 and 12 July 2016. The service was last inspected on 29 January 2014 when all standards inspected were met and no concerns identified. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

Millennium Homecare Services Limited is a domiciliary care agency providing personal care for adults living in their own homes. At the time of our inspection, 163 people were using the service. Millennium Homecare Services Limited provides personal care for people with a range of needs, including dementia, learning disabilities and physical disabilities.

The service had a registered manager at the time of our inspection visit. 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 protected from the risk of abuse and avoidable harm. Risks associated with care were identified and assessed. Staff had clear guidance about how to meet people’s individual needs. Care plans were regularly reviewed with people and updated to meet their changing needs and preferences.

People were happy with staff who provided their personal care. They were cared for by sufficient numbers of staff who were suitably skilled, experienced and knowledgeable about people’s needs. People were also supported by staff in a caring way, which ensured they received personal care with dignity and respect.

The provider took action to ensure that potential staff were suitable to work with people needing care. Staff received supervision and had regular checks on their knowledge and skills. They also received regular training in a range of skills the provider felt necessary to meet the needs of people at the service.

The systems for managing medicines were safe, and staff worked in cooperation with health and social care professionals to ensure that people received appropriate healthcare and treatment in a timely manner.

Appropriate arrangements were not consistently in place to assess whether people were able to consent to their care. The provider was not consistently meeting the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DOLS). However they were taking action to address this at the time of our inspection.

People were supported to be involved in their care planning and delivery. The support people received was tailored to meet their individual needs, wishes and aspirations. People, their relatives, and staff felt able to raise concerns or suggestions in relation to the quality of care. The provider had a complaints procedure to ensure that issues with quality of care were addressed.

Systems were in place to monitor the quality of the service provided and ensure people received safe and effective care. These included seeking and responding to feedback from people in relation to the standard of care. Regular checks were undertaken on all aspects of care provision and actions were taken to improve people’s experience of care.

During our inspection we spoke with managers and directors and looked at nine care records. We spoke with 23 people who used the service and relatives by telephone. People using the service and relatives we spoke with told us that overall they were satisfied with the service they received. Examples of comments made included, “The care staff do a good job”, “I’m happy with the service,” and “Staff are kind and caring.”

People’s care records were personalised and showed that their written consent was properly obtained before they received any care in their home. Where people’s assessed needs identified any risks to their health and welfare, we found their written care plans showed what action staff needed to take to reduce these.

Procedures were in place to safeguard people. We saw staff had received training in safeguarding and people told us that they felt safe in their homes.

Procedures were in place for the management of medication. Risk assessments had been undertaken and all staff had received training in medication.

The provider assessed and monitored the quality of service provided. This was done through audits and seeking people’s views. This meant that the provider ensured people received a quality service.

During our inspection we reviewed care records, staff files, policies and procedures and spoke with members of care staff and to relatives of people who use services.

People who use the service had undergone a full assessment of their care needs and they had discussed and agreed their plan of care. Care staff had undertaken a comprehensive induction programme and had completed all mandatory training.

We found that the provider had undertaken regular surveys of the views of people who use their service and that the results of these surveys were collated and acted upon.

We spoke by telephone to the relatives of two people who use the service. One relative told us that they were 'happy with the care provided' and that the provider 'can be flexible over the times for care delivery to support hospital appointments and such'. Another relative told us that they were 'very happy with the service. The staff are trustworthy and I am at ease with them being in the house'.