This inspection took place between 19 June and 29 June 2018 and was announced. The service is a domiciliary care agency. It provides personal care to older and younger people who may have learning impairment, and live in their own houses and flats in the East Yorkshire region.

At the time of our inspection, 234 people were using the service.

At our last inspection we rated the service Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Staff received training to safeguard people from avoidable harm and abuse. The provider had policies and procedures in place which supported staff to raise concerns and report any concerns they may have to the appropriate manager or external agencies. Risk assessments were in place and the provider was in the process of reviewing some of these so that they contained additional guidance for staff. Medicines were managed safely, we identified one recording issue. Regular audits identified any area that required improvements.

The provider had a system in place to ensure that care visits were scheduled to meet people’s needs and requirements. We received mixed feedback from staff about whether the provider incorporated sufficient travel time on rota’s for them to deliver care and support at the times required. People we spoke with told us they received their calls on time give or take five minutes and that staff had not missed any of their calls. Staff received training on various subjects and could complete additional distance learning to further develop their skills and knowledge. Staff received regular supervision and appraisal. People’s nutritional needs were assessed and support was provided with meal preparation and assisting people to eat and drink, where this was part of their care plan.

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 provider ensured that where people had a legal representative in place, the appropriate confirmations were sought and records kept. Staff described how they supported people to remain as independent as they could be, whilst protecting their human rights. Staff could tell us how they respected people’s privacy and dignity. There was a complaints procedure in place. Records we viewed showed that complaints were investigated and responded to in line with the provider’s policy.

People and their relatives were happy with the care they received. Some people felt staff went above and beyond to meet their needs. Records showed people were involved in their care and support planning and where people had expressed a wish for their relatives to be involved, staff ensured they were invited to important discussions such as reviews of care and support needs. Staff supported people to access hospital and GP appointments when needed. Records showed some people received regular visits from district nurses, such as those people with diabetes that required regular monitoring and insulin injections.

The provider had a quality assurance system in place which improved practices within the service. Information relating to incidents and accidents was shared with staff so that lessons could be learnt and continuous improvements sustained. The provider worked in partnership with other organisations to ensure best practices were adhered to. People and their relatives felt the management and leadership worked well to ensure care and support was consistently delivered. The provider supported staff to develop their skills and knowledge through training, supervisions and invitin

This inspection took place on 19 and 26 April 2016 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the location office when we visited.

New Concept Care Market Weighton is a domiciliary care agency that provides support to people who live in their own home, both younger adults with disabilities and older people. They provide a service throughout the East Riding of Yorkshire to people who have a service commissioned via the local authority and to people who are privately funded. The office is in Market Weighton. At the time of our inspection 299 people were receiving support from the service. Some of the people using the service had complex support needs and received 24 hour support from the service. Others only required time-limited care calls each day.

The service is required to have a registered manager, and at the time of our inspection there was 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.

The provider had policies and procedures in place to guide staff in safeguarding vulnerable adults from abuse, and staff we spoke with understood the different types of abuse that could occur and were able to explain what they would do if they had any concerns.

We found that people’s needs were assessed and risk assessments were in place to reduce risks and prevent avoidable harm. There were some historical inconsistencies in paper copies of risk assessments held in the office, but the care documentation and risk assessments that staff used in people’s homes and the computer records held at the office were consistent and up to date.

The provider had a safe system for the recruitment of staff and was taking appropriate steps to ensure the suitability of workers.

Most people that we spoke with told us that staff usually arrived on time, or within the 20 minute timeframe allowed for the start of the care call. On occasions when there was staff sickness other care staff covered their calls, which resulted in some calls running late. However, we were told this was not often, and nobody we spoke with told us that any of their care calls had ever been missed.

Where staff supported people with their medication, we found that this was accurately recorded on Medication Administration Records. Staff had received training in administering medication and the provider completed audits of medication records and staff competency assessments. This showed that there were systems in place to ensure people received their medication safely.

Staff completed a range of training to help them carry out their roles effectively, and there was a schedule for refreshing this training when it was required. Staff received supervision and appraisal.

The registered provider sought consent to provide care in line with legislation and guidance. We saw that care plans were signed by the people using the service where they had the capacity to do so. Staff had completed Mental Capacity Act (MCA) workbooks and were able to demonstrate an understanding of the principles of the MCA.

People were supported to maintain good health and access healthcare services. We saw evidence in care files of contact with other healthcare services, such as community learning disability services and district nurses. People were also supported with their nutritional needs, where this was part of their care plan.

People told us that the staff who supported them were caring and that they felt involved in decision making about their care. People also reported that they felt their privacy and dignity were respected. Staff we spoke with demonstrated a caring

We visited New Concept Care for a scheduled inspection. We also sent out surveys to people who used the service and relatives, and we spoke to people who used the service on the telephone. Overall people told us they were very happy with the care they received. We saw that care plans were detailed and very personalised.

We saw evidence that the agency worked collaboratively with other agencies and organisations to ensure that the care being provided to the person was holistic and considered all the elements of need each person had.

Staffing levels were monitored and managed appropriately and there were sufficient staff employed to cover the care being provided. There were comprehensive quality assurance and monitoring systems in place to ensure that development of the service was appropriate. People who used the service were given opportunities to feed back about their experiences.

We looked at records and paperwork and found that these were accurate and maintained to a high level meaning that information was up to date and relevant. There was an appropriate amount of detail in records where needed and paperwork was stored and disposed of safely.

We spoke with three people who received a service from the agency and two relatives of people who received a service. In addition to this, we spoke with three care workers and office staff.

The people who received support from the agency told us that they were happy with the service they received. One person said, “With this agency I have regular carers and they know the routine”. We saw that people had been involved in the development of their care plan. Care plans included information about the individual support that people needed from care workers.

Staff confirmed that the training they had undertaken on safeguarding adults from abuse had enabled them to identify different types of abuse. Staff were recruited following robust policies and procedures and this resulted in only people considered suitable to work with vulnerable adults being employed. Staff received induction training before they worked unsupervised with people who received a service from the agency.

Some people required assistance with the administration of medication and they told us that staff were reliable and that they had no concerns about the support they received.

People told us that they knew how to make a complaint. One person said, “I have been with the agency for over eight years and I have never had to make a complaint”. Other people told us that they felt they were listened to when they contacted the agency office.

As part of our inspection we visited one couple who received a service from the agency and with the consent of other individuals we telephoned them at home the following day.

People who spoke with us were very happy with the service.

Individual comments included

“I am really pleased with the service. The care is very good”

“The girls are good and turn up on time”

“The service has given my relative a new lease of life”

“The care workers respect our privacy and dignity at all times. They listen to us and nothing is too much bother for them”.

People told us that the agency carried out quality assurance “Spot checks” and that they were aware of the complaints service and knew how to use this if needed. People said they had completed satisfaction questionnaires and took part in the care planning process.