About the service:

PBL Care Limited is a domiciliary care service that provides personal care to people in their own homes. Not everyone using PBL Care Limited receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, 35 people were using the service.

People’s experience of using this service:

• People were protected from harm and abuse by staff who received training and ongoing support from management to help them work safety.

• People received a consistent and reliable service, provided by staff they were familiar with.

• People had any support needed from staff to take their medicines safely.

• The provider took steps to protect people, staff and others from the risk of infections.

• The provider sought to learn from any accidents or incidents involving people or the staff supporting them.

• New staff received an effective induction to help them settle into their new roles.

• People’s needs and wishes were assessed before their care started and kept under regular review.

• The provider worked with community health and social care professionals to ensure positive outcomes for people.

• Staff sought people’s permission before carrying out their day-to-day care.

• Staff approached their work in a kind and compassionate manner, and treated people with dignity and respect.

• People’s care and support was tailored to their individual needs and requirements.

• People and their relatives felt confident about raising any concerns or complaints with the provider.

• The provider promoted a positive and inclusive culture within the service, based upon open communication with others.

• Staff felt valued and well-supported by an approachable management team.

• The provider had effective systems and processes in place to monitor and improve the quality and safety of people’s care.

We found the service met the requirements for ‘Good’ in all areas. For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

At the last comprehensive inspection, the service was rated Requires improvement (inspection published on 15 March 2018). At this inspection, the overall rating of the service was Good.

Why we inspected:

This was a planned inspection based on the service’s previous rating.

This Comprehensive inspection took place on 18 December 2017 and was announced. PBL Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults some of whom live with dementia. Most of the people who used the service were supported by family members who also provided personal care such as providing medicine administration, meals and drinks. This is the first time the service was inspected since it was registered in December 2015. At the time of the inspection 36 people were using the service.

There was a registered manager in place who was present during 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.

Prior to our inspection we received information of concern from a whistle-blower regarding the leadership of the service. During our inspection we found that the provider had failed to operate effective systems and processes to assess, monitor and improve the quality of the service. The provider had not identified or taken effective action when people constantly failed to receive their calls as planned or when records were not completed by care staff. This put people at risk of not receiving all the care and support identified as necessary in their care plans. There were no process to ensure spot checks and audits would be carried out consistently. You can see what action we told the provider to take at the back of the full version of the report.

People were protected from harm by staff who were aware of signs which may indicate that someone was being abused and the action to take. There were assessments of the risks associated with people’s specific conditions which provided guidance for staff about how they could reduce the possibility of harm. There were appropriate checks to ensure staff were suitable to support the people who used the service. Staff received medicines administration training and felt confident to support people to take their medicines when needed. People were protected from the risk of harm by the prevention and control of infection.

Staff received regular training and knew how to meet people’s specific care needs. People received suitable nutrition in line with their care needs. Staff communicated effectively between themselves and with other organisations. People were supported to make use of the services of a variety of mental and physical health professionals including GPs and dieticians. Staff respected people’s choices. When necessary there were meetings to identify how people could be supported in line with their best interests.

People described the staff who supported them as friendly and pleasant and staff said they had developed positive relationships. People were made to feel their views were important and influenced how the service was run. Staff treated people with respect and promoted their independence.

People were regularly supported to express their views about how they wanted to be supported. People were supported by staff they liked and who knew how to meet their care needs. People’s changing care needs were identified promptly and reviewed. People were able to feed back their experience of the care they received and had access to a formal complaints procedure if they wanted.

People said they were happy with the support they received from the leadership and staff. The registered manager understood their regulatory responsibilities to the commission. They had responded openly and honestly when they had received information of concern in line with their duty of candour. Staff felt confident they could raise concerns if necessary. The registered manager had worked with ot