About the service: Peak care Home Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats within the village of Ashover. The service also provides a service within an extra care facility managed by the provider. At the time of the inspection 21 people were receiving a service; 16 people were receiving support with personal care.

People’s experience of using this service:

Improvements were needed to ensure all information about people’s care was available within the office. Where people started to receive support, care plans needed to be developed in a timely manner. Quality monitoring systems needed to be developed further to review the care people received when living in their own homes in the community.

The staff understood how to protect people from harm and were confident that any concerns would be reported and investigated by the registered manager. Some people received assistance to take medicines and records were kept to ensure that this was done safely. There were safe recruitment procedures in place to ensure new staff were suitable to work with people.

Staff were supported and trained to ensure that they had the skills to support people effectively. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People could make decisions about how they wanted to receive support to ensure their health needs were met. When people required assistance to eat and drink, the provider ensured that this was planned to meet their preferences and assessed need.

People had a small team of staff who provided their support and had caring relationships with them. Care was planned and reviewed with people and the provider ensured that people’s choices were followed. People’s privacy and dignity were respected and upheld by the staff who supported them.

People’s care was reviewed to reflect any changing needs. There was a complaints procedure in place and any concerns received were investigated and responded to in line with this policy.

People were asked for their feedback on the quality of the service and their contribution supported the development of the service. The registered manager promoted an open culture which put people at the heart of the service.

Rating at last inspection: Our last inspection report was published in June 2016 and the service was rated as Good.

Why we inspected: This was a planned inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

There was no registered manager in post at the time of our inspection. The provider told us a manager had started work at the care home located on the same site and that arrangements were being made regarding the management of Peak Care Homecare. The care administrator at the service was providing managerial cover at the time of our inspection.

People said they were happy with the care they received at the service. One person said, "The staff are very good. Nothing would persuade me to leave my apartment here.”

We found that people's consent was obtained for their care, and the provider knew what procedures to use if they could not make their own decisions, for example due to dementia.

We saw people’s needs were assessed and plans were in place about their care. Although staff were knowledgeable about people’s needs, care plans did not always contain information to ensure people received care that met their needs, for example about any health conditions. We saw that assessments were not always in place to help protect people from risks.

At the time of our inspection staff were being recruited and sufficient numbers of staff were available to meet people’s needs.

We found some systems were in place for assessing and monitoring the quality of the service but these were not fully ensuring people were protected from risks. The provider told us improvements were planned for when the new manager was in post.

We spoke with four people who use the service and two relatives of another person who uses the service. We also spoke to one staff member.

We found that people's privacy, dignity and independence were respected. One person told us “I am always treated with respect and the carers always know what care I need.”

We found people experienced care, treatment and support that met their needs and protected their rights. One person told us the service “is very good, actually excellent: a very nice place with well appointed accommodation.” We found people’s care and support needs had been thoroughly assessed and care was delivered in a way that met people’s needs and ensured their safety and welfare.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found the provider had robust systems in place relating to the management of medicines.

The provider had effective recruitment and selection processes in place.

The agency supported people who were living in apartments adjacent to the care home, Grove House, which are both owned by the same provider. Care is offered as extra support if people wanted it. Some of the apartments had communal areas as well as peoples own living areas. The agency also supported some people who lived in the local community in their own homes.

One relative told us that the agency always spoke with them if the staff had any concerns during their visits.

One person told us that they were able to contact staff through a call system at any time and that staff had visited them when they had requested it.

The three people who used the service and one relative we spoke with told us the service was a reliable one and that no calls had ever been missed.

One person told us that staff always knocked on their door before entering but often entered without waiting to be invited in.

Peak Homecare provides personal care to people who live in their own homes around the village of Ashover. This is a small service providing care to around 20 people. The inspection took place between the 04 and the 14 November 2015 and was announced.

At our last inspection carried out in December 2013 we found that the provider was not keeping people safe because the care plans did not contain sufficient information on how to care for people. We also found that the provider had not ensured systems for monitoring quality were fully effective in assessing and managing risks relating to the health, welfare and safety of people at the service. At this inspection we found that these concerns had been addressed.

The service did not have a registered manager in post. The home is required to have a registered manager. 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 our inspection the acting manager at the service had applied for registration with the Care Quality Commission.

People were safe and the provider had effective systems in place to safeguard people. Their medicines were administered safely and they were supported to contact their GP should they need to. The provider had a complaints policy in place.

There were sufficient, skilled staff to support people at all times and there was thorough recruitment processes in place. Staff were trained to care for people and they used their training effectively to support people. They were caring and respected people’s privacy, independence and dignity.

The staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards. The provider had policies in place to ensure people who did not have the ability to consent to their care were protected from the risks of inappropriate care.

Staff were encouraged to contribute to the development of the service and understood the provider’s visions and values.

There was an effective quality assurance system in place.