About the service: Premier Care is a domiciliary care service which provides support with personal care, shopping, domestic tasks and companionship to people living in their own homes. At the time of this inspection 558 people were using the service.

People’s experience of using this service: People and staff told us they felt safe at the service. People received support to take their medicines safely. Risks to people's well-being were recorded and updated when their circumstances changed. Staffing was provided at safe levels and people told us at the times they preferred.

People's rights to make their own decisions were respected. People were supported to access healthcare services. Staff were skilled and knowledgeable in the care and support people required.

People received caring and compassionate support from the staff. Staff referred to people in a respectful way. People were complimentary about staff and the positive relationships they had with them. Staff respected people's privacy and dignity and people were supported to be as independent as possible.

People knew how to complain.

The service had recently experienced change in relation to the management team and implementing new electronic systems. Work to continuously improve was noted and the management team were keen to make changes that would impact positively on people’s lives. Quality checking systems were in place and the service had a robust plan to address any areas for improvement. The service worked well with other community partners.

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

Rating at last inspection: Good (report published November 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

This inspection took place on 12 July 2016 and was announced.

Premier Care provides support and personal care to adults across Nottinghamshire and Derbyshire. The service is managed from an office in Pleasley near Mansfield, Nottingham. On the day of our inspection 301 people were using the service each week.

The service had 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 told us that they felt safe while receiving care from their care staff, although repeatedly people commented on the lack of regular staff which made them feel more at risk. However, there were enough staff to ensure that people received their calls at the planned time and meet their care needs.

Staff took the necessary steps to keep people safe and understood their responsibilities to protect people from the risk of abuse. Potential hazards were identified and detailed plans were in place to enable staff to support people safely. Where required, people received the support they needed to safely manage their medicines.

Staff were provided with support and training but people felt that they did not always have the knowledge and skills they needed to care for them effectively. Staff received supervision of their work.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The provider was aware of the principles of the MCA and how this might affect the care they provided to people. Where people had the capacity they were asked to provide their consent to the care being provided.

Where people required support to eat and drink enough, this support was provided. Staff made sure that people had access to their GP and other health care professionals when needed and would have no hesitation in ringing 999 for an ambulance, if they felt that this was required at any time.

Positive and caring relationships had been developed between staff and people who used the service. People were involved in the planning and reviewing of their care and making decisions about what care they wanted. People were treated with dignity and respect by staff who understood the importance of this.

People’s care plans were written in a way that focused on people’s choices and preferences. A complaints procedure was in place and people felt comfortable to speak up if they were unhappy about any aspect of the service they received

The culture of the service was open. People were supported by staff who were clear about what was expected of them and staff had confidence that they would get the support they needed from the registered manager, both during and outside of office hours. The registered manager undertook audits and observed practice to ensure that the care provided met people’s needs.

During this inspection we attempted to contact twenty four people, which represents over 20% of the total number of people who used the service. We spoke directly with eighteen people, four of which requested we spoke with a family member of friend on their behalf. We spoke in person with two relatives who were at the provider's office during the inspection. In addition to this we spoke with the director, registered manager, three care support workers and the training manager.

We found that people's views were taken into account and their independence and dignity were respected. One person who used the service told us,“I have choices and the care plan is personalised, I have help to go to bed, and with making tea and lunch.”

People felt they were safe, had their needs met and were well cared for. One person who used the service told us,“The service I get is first class and I feel safe when I am cared for.”

People were protected from the risks of unsafe or unsuitable equipment. One staff member we spoke with told us, “Premier Care have given us training on how to use hoists, slings and how to move people safely. I am very confident in using all of the equipment. Having the training has helped.”

Staff were supported in their role and encouraged to obtain further qualifications to develop their expertise.

People's views, comments and complaints were encouraged and acted upon. "The office people visit me and ask for feedback. They set up the necessary changes.”

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with three people who used the service and two relatives and asked them for their views. We also spoke with three care workers, two team leaders, the acting manager and one of the company directors. We also looked at some of the records held in the service including the care files for eight people.

We found people gave consent to their care and treatment and received care and support that met their needs. A relative told us, “We have got a care plan which I have read and it is right. I was asked to sign it to agree to it, which I did.” A person who used the service told us, “I am more than happy with the carers, I am proud of them. They come on time all the time and get on with the job straight way. They respect us in our home. “

We found there were suitable arrangements for the management of medicines and there were sufficient and suitable staff available.

We found people’s comments and complaints were acted upon. A person who used the service told us, “It is a very good service, I cannot fault any of them. I can talk to them. I have been told how I could make a complaint if I want to.” Another person told us, “I know about making complaints. I have not ever needed to in the three years I have used them.”

We spoke with four people who received a personal care service from Premier Care. They told us that they were happy with the service they had received, and the staff were kind, caring and efficient, and they usually turned up when they were expected.

Specific comments included: “On the whole they have done a good job and the staff work hard.” “The staff are all friendly and knowledgeable.” “I’m really satisfied with the help I get.” “I am delighted with them. Yes, they (the staff) definitely do treat me with respect.”

“The staff are particularly good in the way that they look after me, I can’t fault the staff in any way at all.”

We asked people who use Premier Care’s services if they felt safe. Everyone we spoke with said that they did feel safe, and they had no concerns about their welfare.

Of the four people who receive a service from Premier Care who we spoke with; two people said they had completed a survey, and given feedback to the agency.