Positive Care Services Limited is a domiciliary care agency registered to provide personal care to adults living in their own homes. Not everyone using Positive Care Services Limited will necessarily receive 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 there were eleven people using the service, all of whom were receiving personal care.

This was the first inspection of the service since it was registered in June 2017. The inspection was announced and took place on 1 August 2018 with follow up phone calls carried out on 3 and 6 August 2018.

At the time of inspection there was a registered manager in post who was also the registered provider. 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 and associated Regulations about how the service is run.

People felt safe using the service. Staff were aware of their safeguarding responsibilities and knew what to do to keep people safe. Staff were aware of the risks to people and how to manage risks to ensure people’s safety and well being.

We made a recommendation about risk recording to ensure sufficient written guidance was available for staff to refer to.

People were supported to take their medicines safely by staff who had been trained and assessed as competent to administer medicines.

There were sufficient staff employed who had been safely recruited. Robust systems were in place to monitor people’s visits to check that calls were not late, cut short or missed.

Accidents and incidents were recorded and analysed to monitor people’s safety. Lessons had been learned and systems and processes adapted to improve the safety and quality of the service.

Staff received an induction, training and supervision to support them to be competent in their role. Staff felt well supported and were regularly observed to check their performance and identify any learning needs.

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. People's consent was sought before care and support was provided.

People were supported to have enough to eat and drink and received support to access treatment from healthcare professionals if their health needs changed.

Staff were kind and caring and listened to people. People were treated with dignity and respect and independence was supported and encouraged.

People’s needs had been assessed and care plans formulated which described people’s care and support needs. However, improvements were required to ensure written care records were ‘person-centred’ to reflect people’s routines and preferences.

Staff had received training in end of life care and the service had formed links with the local hospice to provide additional guidance and support to staff if needed.

There were systems and processes in place to respond to complaints. People had access to the company’s complaints policy and knew how to make a complaint. Feedback from people and staff was actively sought to drive improvements.

There was a registered manager in post who was supported by a care manager in the day to day running of the service. People and staff were positive about the management team who were ‘hands-on’ and visible within the service.

Quality assurance systems were in place to monitor the safety and effectiveness of the service. There was robust oversight of the service and clear lines of accountability at staff, management and provider level.

Further information is in the detailed findings below.