Positive Support For You CIC is a domiciliary care agency. It provides personal care and support to people living in their own homes. It provides a service to a range of people including those living with mental health needs and physical disabilities. At the time of inspection there were 25 people using the service and five were receiving the regulated activity of personal care.

At the last inspection the service was rated 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.

There was a registered manager in post who had been registered with the Care Quality Commission (CQC) since May 2015. A registered manager is a person who has registered with the CQC 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 registered manager was aware of their responsibilities and had a clear strategy and vision for the service in partnership with the provider's organisational vision. This was to support people to achieve their needs and wishes.

There was a robust governance framework in place which was used to monitor the quality of the service provided to people. There were monthly audits completed by the registered manager and the provider. Notifications were submitted to the Commission appropriately.

People accessing the service were supported to maintain social relationships and participate in activities that they chose. Relatives told us that staff continued to respect people’s privacy and provide kind and caring support responsive to people’s needs. Staff were knowledgeable about people they supported. Medicines were safely managed. Staff supported people with their medication. There was a business continuity plan in place to enable people to receive their care in emergency situations.

People had personal and environmental risk assessments in their care files, to ensure the safety of staff and people. Care plans were person-centred and people, their relatives and advocates had all been involved in their care planning and consented to the care provided. The service worked in partnership with health professionals, for example the district nursing team and positive behavioural support team, to ensure people received a high level of quality care. People were supported with their diet and to make well balanced meals. People were regularly asked for their choices for the type of support they received, for example social visits and types of personal care, and for continual feedback.

There were policies and procedures in place to keep people safe. Staffing levels reflected the needs of people. Staff were recruited safely and were provided with an in-depth induction. The registered manager continuously assessed the skills of staff and provided an on-going training programme, which was delivered face to face or via e-learning. The service provided information to staff on best practice guidance and legislation. Staff received regular supervisions and appraisals.

There was a comprehensive complaints and compliments policy in place at the service. Relatives told us they knew how to raise a complaint. One complaint had been received at the service since our last inspection and was fully investigated and actioned by the provider. People received service user guides which included information about the service, safeguarding, information about service user interests and complaints. All information was available in easy read, pictorial and if needed in other languages.

Further information is in the detailed findings below.

The inspection took place on 21 March, 20 April, 21 April and 28 April 2016. The inspection was announced which meant that we gave 48 hours’ notice of our visit. This was because the location provides a domiciliary care service and we needed to be sure that the registered manager would be available.

The service was registered with the Care Quality Commission on 14 January 2014. They were previously inspected on 30 January 2014 and found to be compliant with all regulations inspected at that time.

Positive Support in Tees Community Interest Company is a domiciliary care agency registered to provide personal care to people in their own home. At the time of our visit there were nine people receiving support that included regulated activity.

The service had a registered manager in place. 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.

People and their relatives told us they felt that care was delivered safely. Wherever possible the same staff attended calls which meant that people knew the staff that were supporting them. This was not always possible when new staff were recruited but new staff were never sent to a call without being accompanied by a member of staff who was known to the person.

There were systems and processes in place to protect people from the risk of harm. Individual risk assessments were in place and covered key risks specific to the person. They included things such as absconding, self-harm and epilepsy. These forms were regularly reviewed and updated as required.

The service had an up to date safeguarding policy and information on safeguarding was given to people who used the service in easy read format. Staff were able to tell us about different types of abuse and were aware of the action they should take if they suspected abuse was taking place. Staff were also aware of whistle blowing [telling someone] procedures.

We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken prior to staff starting work.

The service had policies and procedures in place to ensure that medicines were handled safely. Accurate records were kept to show when medicines had been administered and any errors were appropriately recorded and reported.

Appropriate environmental checks had been done on people’s homes to ensure health and safety of staff and the people they cared for.

The service recorded accidents and incidents in a dedicated accident/incident log and these were analysed monthly.

Staff received appropriate training and had the skills and knowledge to provide support to the people they cared for, this included specialist training specific to the needs of the people using this service. New staff underwent induction training which included shadowing a more experienced colleague.

Staff had a working knowledge of the principles of consent and the Mental Capacity Act and understood how this applied to supporting people in their own homes.

Staff received regular supervision and annual appraisals to monitor their performance.

People were supported to access external health services such as dentists and opticians to ensure their general health and wellbeing.

Staff were aware of people’s dietary requirements and any extra support needed at mealtimes. Records were kept to ensure people enjoyed a suitable, healthy diet and maintained a good level of nutrition.

Staff were knowledgeable about the people they provided care to and were mindful of respecting people’s privacy and dignity.

Staff were happy in their job and had a positive attitude about the care provided by the service. Relatives we spoke to felt that the staff delivered a good standard of care.

Care plans

We found that the provider had recently moved to new premises in Eaglescliffe.

Not all of the people who receive personal care could express their views, but those that could did so freely. We were able to speak to four relatives and two health care professionals as well as staff at the service either on the day of the inspection or just after the inspection visit. We also visited one person at their home in the community. The majority of people that we spoke to were very complimentary about the service and the care that the staff provided. One person said, “The staff are great.”

We found that the provider had detailed information and care plans about people in their care and that information was updated as needs changed. One health professional confirmed this.

We found that people were protected from abuse and that they felt safe within the service provided. One relative told us, “I have no problems.”

Generally we felt that staff were supported within the service. One staff member said that they received regular supervision.

The provider showed evidence that regular monitoring of the quality of the service took place and people and their relatives views were listened to.

We found that overall; records were accurate and fit for purpose.