This inspection took place on the 20 September 2016 and was announced. We gave the provider 48 hours’ notice that we would be visiting. This was because the provider offers a supported service to people living in their own homes and we wanted to make sure that people and staff would be available to speak with us.

Nationwide Care Ltd (Birmingham & Solihull) is a community based adult social care service, registered to provide personal care for persons within their own home. They currently provide a service for more than 300 people.

There was a registered manager in post at the time of our inspection. 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 previous inspection in December 2014, Nationwide Care Services Ltd were rated as good overall, with some improvements required regarding ‘Well Led’, in particular; auditing of records and communication with staff and people that use the service. We saw that although auditing processes had improved, there were still some issues regarding communication and responding to peoples care and support needs when regular staff were unavailable.

People were kept safe. Relatives believed their family members were kept safe. Staff had received training and understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. Staff were provided with sufficient guidance on how to support people’s medical support needs. People were kept safe by staff that were able to recognise the signs of abuse and raise concerns if needed.

People were supported by staff that had been safely recruited. Relatives felt that their family members were being supported by staff with the appropriate skills and knowledge to care and support them. People were supported with their medication by staff that had received appropriate training.

Staff were trained and supported so that they had the knowledge and skills to enable them to care for people in a way that met their individual needs and preferences. People were supported to make choices and were involved in the care and support they received. Staff had an awareness of the Mental Capacity Act and Deprivation of Liberty Safeguarding (DoLS).

Staff were caring and treated people with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s care and support needs.

People and relatives felt they could speak with the provider about their worries or concerns and felt they would be listened to and have their concerns addressed.

The provider had quality assurance and audit systems in place to monitor the care and support people received to ensure the service remained consistent and effective.

We undertook an announced inspection of Nationwide Care Services Ltd (Birmingham and Solihull) office on 16 December 2014 and 10 February 2015. We told the registered manager two days before our visit that we would be coming.

This was the first inspection of this location which was registered on 11 June 2014.

Nationwide Care Services Ltd (Birmingham and Solihull) is a domiciliary care service that provides care and support to people living in their own homes. Some people’s care was funded by Solihull and Birmingham Local Authorities and some people purchased their own care. At the time of our inspection 300 people received support from this service.

There was a registered manager in post at the time of our inspection. 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 abuse because staff were able to recognise the signs and symptoms of abuse and knew how to raise concerns. Staff had received training that enabled them to provide safe care and support. There were sufficient numbers of trained staff that had had the appropriate recruitment checks to ensure that people received safe care and support.

People told us that they were happy with the care and support they received from their regular care workers who were knowledgeable about their needs and attended at the agreed times. Some people were not always happy with the care and support they received from replacement care workers because they were not aware of their needs and sometimes did not attend at the agreed times.

People told us that they were asked for their consent to the care and support they received this involved an assessment of their needs. This meant that people’s rights were protected and consent to care and support was obtained before it was provided.

People told us they had developed caring and friendly relationships with their care workers. People’s privacy and dignity was usually maintained and their independence promoted.

There were systems in place to gather the views of people on the quality of the service to ensure this was provided appropriately. People told us that they had no problems with the care workers but they were not always happy with the responses and communication with office staff.