This inspection took place on 11 July 2017 and was announced. We gave the service 48 hours' notice to make sure there was someone at the office to assist with our inspection. Further days of inspection took place on 12 and 18 July 2017 and were announced.

My Choice Homecare is a domiciliary care service that provides personal care and support to older people and people living with dementia. The service covers the Consett area of County Durham. At the time of our inspection 46 people were receiving support with personal care from the service.

The service was last inspected in June 2016. At that time we identified two breaches of our regulations in relation to fire risk assessments and staff training, supervision and appraisal. We took action by requiring the provider to send us action plans setting out how they would address these issues. When we returned on our latest inspection we saw improvements had been made.

All of the people and relatives we spoke with said they felt safe using the service. Risks to people were assessed and plans put in place to reduce the chances of them occurring. Medicines were managed safely and people told us they received their medicines when they were needed. Policies and procedures were in place to safeguard people from abuse.

The provider monitored staffing levels to ensure sufficient staff were deployed to provide safe support. People told us they were supported by stable staffing teams whose timekeeping was good. The provider’s recruitment process reduced the risk of unsuitable staff being employed. Staff were supported through regular training, supervision and appraisal.

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

Where people received support with food and nutrition as part of their care package they spoke positively about the help they received. People were supported to access external professionals to maintain and promote their health and wellbeing. The provider had a business contingency plan to ensure people received a continuity of care in situations that disrupted the service.

People and relatives spoke very positively about the support provided by staff, who they described as kind and caring. People and their relatives said staff went above and beyond what was expected when delivering support. People told us staff worked hard to help them maintain their independence and treated them with dignity and respect. The service had received a number of compliments from people and their relatives on the quality of care delivered by staff. The service had procedures in place to help people access advocacy services where needed.

People received personalised care based on their assessed needs and preferences. Care plans were regularly reviewed to ensure they reflected people’s current needs and preferences. Some people received support to access activities as party of their care package. Where this was the case people spoke positively about the support they received. Policies and procedures were in place to respond to complaints.

Staff spoke positively about the culture and values of the service and said the provider and manager were supportive of them in their role. The manager and provider carried out a number of quality control checks to monitor and improve standards at the service. The provider and manager sought people’s feedback on the service. The manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.

The inspection took place on 9, 10 June 2016. The inspection was announced as My Choice Homecare provides domiciliary care to people in their own homes. We gave the service 24 hours’ notice to make sure there was someone at the office for the time of our inspection.

My Choice Homecare is a domiciliary care service that provides personal care and support to older people and people living with dementia. The service covers the Consett area of County Durham and at the time of our inspection the service supported 51 people.

At the time of our inspection the service had a registered manager in place. 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 the registered manager was unavailable due to ill health and the inspection was carried out with the deputy manager.

We spoke with care workers who told us that the registered manager and deputy manager were always approachable. We spoke with people who used the service on the day of the inspection and their relatives who also told us the registered manager and deputy manager were always supportive, accessible and open.

We looked at staff training and found that not all staff had the same amount of training and some staff had gaps in their training records.

Staff had received a recent appraisal but no regular supervisions were carried out or planned in accordance to the services policy.

We saw that people’s prescribed medicines and topical medicines were recorded when administered. We looked at how records were kept and spoke with the deputy manager about how staff were trained to administer medicines. We found that the medicine administration, recording and auditing process was safe; however the auditing system needed strengthening.

From looking at people’s support plans we saw they were person centred. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes and needs and choices are taken into account. The support plans described individual’s care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the registered manager.

People who used the service received person centred support and their individual needs were respected and valued.

Individual support plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary. For example, the mental health team, GP or care manager.

Our conversations with people who used the service and their relatives showed us that people who used the service were supported in their own homes by sufficient numbers of staff to meet their individual needs and wishes.

We looked at the recruitment process and found that relevant checks on staff took place and this process was safe. People who used the service where matched with staff according to preferences and interests as part of the recruitment process.

People where possible were encouraged to participate in activities that were personalised and meaningful to them. People were supported regularly to play an active role in their local community, which supported and empowered their independence including accessing local facilities.

We saw a compliments and complaints procedure was in place. This provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services and safeguarding contact details if they needed them.

We found the service had been regula

On the day of our inspection we visited four people who were supported by My Choice. We spent time observing how staff supported people. We found staff were very respectful in their approach, treating people with dignity and courtesy. People who used the service were very positive about the staff. Comments included “It’s ideal, they would do anything for you”, “They definitely treat me as an individual” and “They are really good with personal care, they respect my dignity.” One relative told us she had used several domiciliary care agencies previously and was happy with My Choice. She said “The staff don’t talk over (relative’s name), I’ve watched them and they treat (name) with respect and dignity.”

We spoke with some relatives who told us they were very happy with the care and support provided. Comments included “This is the best agency we’ve ever used”, “They were highly recommended by other relatives and we are pleased with them” and “They are fantastic, I’ve got confidence in them, we’ve seen a big change in (relative’s name).”

We spoke with seven people who used the service, they all said they were happy with the care and support provided and felt safe. One person said “I can trust them.”

People they told us they spoke to staff and managers directly if they had any comments or concerns. One person said “If I had any problems I would just speak to the manager and am confident she would sort if out”, another said “I wouldn’t hesitate to get in touch.”