The inspection took place on 23 and 24 July 2018 and was unannounced. This is the first comprehensive inspection of this location.

This service provides a range of services to the NHS and adult social care settings. They also provide some domiciliary care packages, these are provided to older adults and younger adults living with a range of health conditions and needs to live independently in the community. Not everyone using Precedo receives 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, three people were receiving personal care as part of their care package.

Prescedo has 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.

People received a service which was safe. We saw that staff understood how to keep people safe and knew how to report any concerns. Risk assessments had been completed to cover all aspects of people’s care, including whilst outside their home. The staff were consistent and the appropriate recruitment checks had been completed. Staff knew how to handle medicine safety and to reduce the risks of infection.

Staff had received training for their role. This involved a range of courses and the latest guidance on specific conditions. When people received support with meals this was done through choice and dietary needs. Health care was monitored and people were supported in this area. 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.

Staff had established positive relationships with people and this was supported by having consistent staff. Respect and dignity had been maintained along with supporting people to remain as independent as they were able to be.

There was a responsive approach to people’s needs. The hours of support were flexible to meet the needs on a week by week basis. The care plans were detailed and included information in relation to people’s equality needs and information access. There had been no complaints to the service, however people felt able to raise any concerns.

The service was supported by a registered manager who understand the regulations and ensured we received notifications and information in relation to these. People had been given the opportunity to reflect on the service they received and to support improvements driving forward. Regular audits had been carried out in relation to the care plans and medicines management. Staff felt supported and enjoyed working for this provider. Partnerships had been established to support the needs of peoples making the links with health and social care professionals.

We visited the Precedo Healthcare Service at their offices in Dronfield where we met with members of the senior management team including the nominated individual. The organisation is registered as a domiciliary care agency although they are actually operating as a staffing and recruitment agency from this location. This means that they do not have any direct contact with people who receive services, although their staff do have contact through placements with other organisations.

We received feedback from four organisations who have staff supplied by Precedo Healthcare Service including the National Health Service (NHS) at Chesterfield Royal Hospital. All four of Precedo Healthcare Service’s ‘clients’ said that they had a good relationship with them and they were very satisfied with the relationship.

We also spoke with three members of staff who said they had been through a robust interview process, and that they had received a thorough induction. All three members of staff said they felt well supported by the agency and were happy to be working for them.

Precedo Healthcare Service are registered as a domiciliary care agency. Although the service actually operates as a staffing and recruitment agency. Staff are placed in care services operated by other providers, particularly the National Health Service (NHS) and private care homes. With staff being placed with the other providers to fill short term vacancies.

We spoke with three of Precedo Healthcare’s clients, who told us that they had a professional relationship with the agency, and that they were perfectly satisfied with the staff that were supplied. We were told that there was good communication, and staff arrived having been through an induction programme covering among other things moving and handling and safeguarding vulnerable adult’s procedures.

One of Precedo Healthcare’s clients told us: “We have used other agencies in the past and consider Precedo to have the best , most competent staff. They are aware of our specialist service and the skills required and we have never had any issues to date.”

We also spoke with three members of staff who said they were well supported by Precedo Healthcare, and had been through a rigorous and thorough recruitment and induction process.

Relatives of service users said they were satisfied with the care they received which they said was to a high standard.