The inspection took place on 14 and 16 November 2018 and was announced.

Millhouse SOS Homecare Limited, provides personal care for people aged 55 and over. This service provides care and support to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant's own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service. There were 14 people receiving personal care when we inspected.

At our last inspection we rated the service good. At this comprehensive inspection we have rated the service 'good' overall but rated the safe question as ‘requires improvement. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was in place. A 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 very positive about the support they received from the service.

Staffing levels were sufficient to provide safe care and people were supported by a small and familiar staff team. Recruitment checks had ensured they were suitable to work with vulnerable adults. We noted that records relating to reference checks could be more robust.

We found some shortfalls relating to medication records, which did not always contain sufficient detail. Records relating to risk did not always reflect the action that had been taken to mitigate risk. Where necessary people had equipment needed. Where we found concerns with records the registered manager was aware of them and had an action plan in place to address them.

Staff were trained and received ongoing support from the registered manager. However, work was being undertaken to ensure that staff supervisions and spot checks were carried out as frequently as required.

People's needs continued to be assessed before they started using the service and were reviewed to develop their care plans. People received appropriate support to meet their nutritional needs.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The service promoted a culture of dignified and respectful care. People told us that were treated by staff who were kind and caring. They were involved in decisions about their care and the development and reviews of care plans. People had close and effective relationships with staff due to the small staff team.

People received care and support that was personal to their needs and was responsive to their changing needs. Each person had a care plan and in some cases. we found they lacked person centred details. However, staff were knowledgeable and had sufficient guidance to meet people’s individual needs.

People had regular contact with the management team, and reported no difficulties in raising any concerns about the service if necessary.

People were positive about the way the service was managed. The service continued to monitor and assess the quality of the service they were providing to people. Internal audits had highlighted some areas for improvement. We recommend the provider continues to monitor and evaluate the existing quality improvement initiatives until improvements are shown to be sustained and embedded in practice.

Staff said they felt supported but raised some concerns about the accessibility of the management team at times. The registered manager told

The inspection was announced and took place on 11 and 14 April 2016.

The service had not been inspected previously.

SOS Homecare provides personal care to people living at Millhouse which offers extra care housing where people have their own individual apartments. They provide personal care and support to approximately 43 older people; people with learning disabilities; physical disabilities; people with mental health needs and complex needs. Staff are provided on site over 24 hours, seven days a week.

SOS Millhouse has 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.

At the time of our inspection, SOS were providing personal care to twenty one people. They also provided a wellbeing service to everyone resident within the Millhouse building. Everyone who had an apartment within the building was provided with a pendant alarm where they could summon assistance 24 hours a day from the service.

The people who used the service and their relatives told us that they were treated with respect and kindness by the staff. Comments included, “Everyone is so friendly and kind”, “I get very good care. I get on well with them” and “They are a very good team of carers”.

Arrangements were in place to protect people from the risk of abuse. We spoke to staff about their understanding of safeguarding and they knew what to do if they suspected that someone was at risk of abuse or they saw signs of abuse.

We looked at the recruitment files of the most recently appointed member of staff and other members of staff to check that effective recruitment procedures had been completed. We found that appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.

The provider had their own induction training programme that was designed to ensure any new staff members had the skills they needed to do their jobs effectively and competently.

We asked staff members about training and they all confirmed that they received regular training throughout the year and that it was up to date. Staff had regular spot checks completed by senior carers to check that the standards of care remained high. Staff also confirmed that they felt supported and received regular supervision throughout the year which again helped them to do their jobs effectively and competently.

Care plans contained a good level of detail and were written in a personalised way so that anyone reading the file would gain a good understanding of the care that was needed for each person. The care plans were reviewed on a regular basis so staff knew what changes in care provision, if any, had been made. Staff members knew the people they were caring for well and many of the staff members had been in post for a number of years which had enabled them to build up good working relationships with the people using the service.

Staff members we spoke with were positive about how the home was managed. All of the staff members we spoke with were positive about the service and the quality of support being provided. They reported being happy in their roles. Comments included, “Everyone looks out for one another” and “We respond to people and we enjoy doing it”.

The service had a quality assurance system in place which used various checks and audit tools such as questionnaires and spot checks to monitor and review the practices within the service. This included audits on medication, daily log sheets and incidents and accidents.