About the service:

Peak Home Care is a domiciliary care agency providing care and support to people in their own homes in the community. The service provides support to predominantly older people, including people living with dementia, mental health needs and physical disabilities.

At the time of our inspection 124 people were using the service.

People’s experience of using this service:

People told us they were safe. The providers processes and practices protected people from abuse. There were enough staff to ensure people’s needs were met. However, one person that was supported to access the community was not always getting these hours due to staff shortages, this was being addressed by the provider.

Recruitment procedures followed safe practices. Staff were given time to provide care and support that was unrushed. People’s medicines were managed safely, however, some minor improvements were made following our inspection.

Risks were identified and managed well. Incidents and accidents were monitored to inform practice and make improvements to the service. People were protected by the prevention and control of infection.

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

Peoples nutritional needs were met. People who required support with their diet had their needs met by staff that understood their dietary requirements. Staff had received the training and support they needed to carry out their roles well. People had confidence in the staff and were happy with the care they received.

People spoke positively about the care and support they received. Everyone we spoke with said staff were very respectful of people’s privacy and dignity and promoted independence where ever possible. One person described their care worker as being. “Excellent and patient, one in a million.”

People received personalised care that was responsive to their needs. Care plan information focused on a person-centred method of supporting people. Information contained what support was required. The care and support plans included people’s decisions and choices. People were supported appropriately at the end of their lives.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. The registered manager kept detailed records of concerns that evidenced any issues were actioned promptly and satisfactorily.

People told us they were listened to and had opportunity to raise concerns if required. Everyone we spoke with was clear about how to raise a complaint. Most people said when they raised concerns they were addressed promptly.

People’s feedback was used to make changes to the service.

The nominated individual and the acting manager conducted a range of audits in areas such as, medicine management, health and safety, care plans and daily records documentation. We saw the monitoring identified areas for improvement and any actions raised as part of the audits were addressed.

More information is in the detailed report.

Rating at last inspection:

At the last inspection the service was rated good. (28/5/2016)

Why we inspected:

This was a scheduled inspection based on the previous ratings.

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

Peak Home Care provides personal care for 150 adults in their own home.

The service is run from an office in Chesterfield and they provide care to people in Derbyshire. We carried out this inspection at the provider’s office on 22 February 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to make sure the registered manager was available.

There was a registered manager at the service. 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.

We found people’s capacity to make decisions was not always assessed. There were no capacity assessments available and no assessments regarding individual decisions.

Consent to care and support had been sought but we found family members were signing documents when it was unclear whether they had the authority to do so.

The service was following the guidance in people’s risk assessments and care plans and the risk of unsafe care was reduced. People’s records were up to date and demonstrated that people had received care in line with their assessed needs. People’s records had also been updated to reflect changes in their care needs.

People were safeguarded from the risk of abuse or harm because the provider had relevant guidance in place and staff were knowledgeable about reporting procedures.

People who were assisted with meals told us this was done well. People’s health needs were met. Referrals to external health professionals were made in a timely manner.

People told us staff were caring and kind and that their privacy and dignity was maintained when personal care was provided. They were involved in the planning of their care and support.

Complaints were well managed. Systems to monitor the quality of the service Identified issues for improvement. These were resolved in a timely manner and the provider had obtained feedback about the quality of the service from people, their relatives and staff.