About the service: Premier Community Care is a domiciliary care service which provides support with personal care to older people and people with physical disabilities living in their own homes. At the time of this inspection 473 people were using the service.

People’s experience of using this service: People told us they felt safe. Medicines were managed effectively. Staff understood their responsibilities about keeping people safe. Risks were identified and managed well. Incidents and accidents were monitored to inform practice and make improvements to the service. Staff understood their responsibilities to prevent the spread of infection whilst working in and between people's homes.

Staff had completed training in key areas and were supported to carry out their roles. People had confidence in staff and were content with the care they received. Staff supported people to access health services if needed. Dietary needs were assessed and, where required, people received support with their meals.

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 told us staff were kind and caring. Staff supported people to remain independent and promoted their dignity. People's privacy was respected and their personal information was kept securely.

People's care plans were up to date about their individual needs and preferences. People received support that met their needs.

The registered manager had a clear vision about the quality of care they wanted to provide. Staff were aware of their roles and responsibilities. There were a number of quality assurance systems in place to monitor the quality and safety of the service. There was a focus on continuous improvement.

Rating at last inspection: Good (report published 1 October 2016).

Why we inspected: This was a scheduled inspection based on the previous rating.

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.

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

This inspection took place on 10, 11 and 22 August 2016. We gave the provider 48 hours’ notice to ensure someone would be available to talk to us.

Premier Community Care Limited was last inspected by CQC on 22 September 2014 and was compliant with the regulations in force at that time.

The service provides personal care to people in their own homes. On the day of our inspection there were 473 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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.

Risk assessments were in place for people who used the service and staff described potential risks and the safeguards in place. Accidents and incidents were appropriately recorded and investigated.

The registered provider’s safeguarding policy defined the procedures to be followed upon discovering abuse or suspected abuse and the registered provider understood safeguarding procedures and had followed them.

Appropriate procedures were in place to ensure people received medicines as prescribed.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Staff were suitably trained and received regular supervisions and appraisals.

The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and consent was obtained from people who used the service.

Staff were aware of people’s nutritional needs and care records contained evidence of involvement from external health care specialists.

People who used the service, and family members, were complimentary about the standard of care provided by the service. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person centred way.

People who used the service, and family members, were aware of how to make a complaint.

Staff felt supported by the management team and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service. Family members told us the management team were approachable and understanding.

During our inspection we asked the provider, staff and people who used the service specific questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they were treated with respect and with dignity by the staff. They said they felt safe. We found safeguarding procedures to be robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that any unsafe practice was identified; this helped to protect people who used the service.

Is the service effective?

People’s health and care needs were assessed with them, and they or their representatives were involved in writing their plans of care. Specialist dietary, social, mobility, equipment and dementia care needs had been identified in care plans where required. Some people said they had been involved in writing them and they reflected their current needs.

Is the service caring?

People told us they were supported by kind and attentive staff. They said workers showed patience and gave encouragement when supporting them. People commented, “The staff do a very good job and they listen to how I like things to be done." Another said, “I feel safe and secure knowing I have someone to help me every day."

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised, we saw these had generally been addressed by the provider.

People’s preferences, interests, aspirations and diverse needs were recorded and care and support was provided in accordance with people’s wishes.

Is the service responsive?

People we spoke with knew how to make a complaint if they were unhappy. One person said that they had made a complaint about a missed call. They told us they were satisfied with the outcome and that it had never happened again.

Although not included in this inspection, we very briefly looked at how complaints had been dealt with, and found that the responses had been open, thorough, and timely. This meant people were assured that complaints would be investigated and action taken when necessary.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. The records we looked at showed any shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the agency and the quality assurance systems in place. This helped to ensure that people received a good quality service.

People or their relatives were able to give consent for the care and support they received.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We visited three people who received support from Premier Community Care. People were satisfied with the care provided. Comments included “It’s OK, not complaining” “We have had no missed calls – only the one’s we have cancelled ourselves.” “Nothing to grumble about – I am well looked after.

People had their medicines at the times they needed them and in a safe way.

There were effective recruitment and selection policies and processes in place.

People were given support by the provider to make a comment or complaint where they needed assistance.

We did not speak with any service users during this visit.

We did not speak with any service users during this visit.

We spoke to five people who received a service from Premier Community Care Ltd. People were normally happy with the help and support that they got from their regular carers. Comments included “staff are lovely” and “the carers are very good”.

People did not like it when the staff kept on changing. One person commented that on one weekend they had a different person for each of their separate visits on a single day. One person who used the service said that the total number of staff for an individual should be limited to two or three.

Two people commented that the service was normally much worse at weekends with carers not visiting at the correct times. One person said that their 9.15 visit, the Sunday befoe the inspection, did not appear until 10.20. Another person described how their 08.00 call on one Sunday called at 06.30 which was too early to get their husband out of bed.

We completed this inspection over a number of days. We visited the provider’s offices to speak with staff and review records on 29 January 2014. We spoke on the telephone with around 12 people who used the service and their families or carer’s on 13 and 14 February 2014. We also sent questionnaires out to 61 people during this time and received 30 responses from people who used the service, their relatives or friends. We received feedback on their responses on 21 February 2014.

The majority of people reponded to the CQC questionnaire that before they started to use the care agency they had been given information about the care and support it could offer. People told us they were treated with dignity and respect. We found people were treated with respect and involved in making decisions about their care.

We found people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. However there was no formal review process in place for people who used the service, their families and representatives to feed in their views and preferences to Bishop Auckland about the care provided.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The majority of people who responded to the CQC questionnaire rated the service either good or excellent.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. However, the provider may wish to note that records kept of audits were very basic. The provider was at an early stage with making identified improvements to their audit processes.