The inspection took place on 29 August 2017 and was announced. When the service was last inspected in May 2015, there were no breaches of the legal requirements identified. The service was rated as good.

Premier Homecare Limited is based in Bristol and provides personal care and support to people living in their own homes. At the time of our inspection 102 people were receiving personal care.

A registered manager was in post. 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.’

Where people were supported with medicines, we found they were managed safely. Risk assessments and risk management plans were detailed and fully completed.

People’s care records were highly personalised, with clear evidence of people’s involvement and that choices and preferences were fully taken into account.

Audits were in place to identify shortfalls and actions were fully completed to make any necessary improvements.

Safe recruitment procedures were followed before new staff were appointed. Appropriate checks were undertaken to ensure staff were of good character and were suitable for their role. The staff induction programme was comprehensive. Staff views were very positive about the support, guidance, training and supervision they received.

People were cared for in a kind and respectful way. People were supported to maintain their health and the service liaised with other external health professionals when needed.

People who used the service, relatives, external health professionals and staff all spoke highly of the leadership and management of Premier Homecare.

The providers showed how they responded positively to feedback and made consistent and continuous service improvements. They worked in collaboration with other professional bodies and within the local communities to enhance and improve the quality of service for people living in their own homes.

We undertook an announced inspection of Premier Homecare on Tuesday 14 April 2015. When the service was last inspected in April 2013 there were no breaches of the legal requirements identified.

Premier Homecare provides personal care to people living in their own homes within the Bristol and South Gloucester area. At the time of our inspection the service was providing personal care and support to 145 people.

A registered manager was in post at the time of inspection. 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 felt safe and staff knew how to respond to actual or suspected abuse. The provider had a safeguarding adults policy for staff that gave guidance on the identification and reporting of suspected abuse.

People’s care appointments were undertaken by the staff at the service as planned and there were sufficient staff available to meet people’s needs. Staff told us that staffing levels were sufficient and told us they had time to meet people’s needs.

People received their medicines on time and the service had arrangements in place for the ordering and administration of medicines. Medicines records had been completed appropriately and the provider had an auditing system to monitor people’s medicines.

People praised the care they received from the staff and told us they received a high standard of care. Staff were provided with regular training and supervision processes and staff felt supported.

People were asked for their consent before any care was provided and staff acted in accordance with their wishes. Staff understood their obligations under the Mental Capacity Act 2005 and how people should be supported to make informed decisions.

People were supported to see healthcare professionals when required and records showed that staff responded promptly to people’s changing needs. The service had appropriate systems that ensured referrals to healthcare professionals were made.

There were caring relationships between staff and people. People spoke very highly of the staff that provided their care and we also received very positive feedback from people’s relatives. People and their relatives were involved in decisions about the care package they received.

People’s care records showed people’s involvement and the decisions they had made in their care planning. People and their relatives spoke positively about the communication from the management and staff from the service.

People told us they received the care they needed and when they needed it. All said their agreed care package met their needs. The provider had developed systems to ensure that people’s care needs could be met by new or unfamiliar staff.

The provider had a complaints procedure and people had been given appropriate information about how to raise a complaint if required. People were confident they could complain should the need arise and felt that any issues identified would be addressed by the management.

The registered manager was highly spoken of by the staff. Staff felt very supported in their roles and the management had sufficient systems to communicate with the staff. The provider was involved in a pilot hospital discharge initiative to speed up hospital discharges for people in the local area.

People and their relatives knew the management structure within the service. Staff told us they worked in a supportive environment and they felt listened to. The registered manager had systems to continually monitor the quality of care provided and auditing systems to monitor records and documentation used by staff.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this agency as part of a targeted inspection programme of domiciliary care agencies.

The inspection team was led by a CQC inspector joined by an expert by experience, who has experience of using or caring for someone who uses this type of service.

As part of our inspection of this service we telephoned 15 people who used the service, we visited four people who received a service, spoke with eight members of staff, the manager and the administrator of the service. One of the people we spoke with told us, "the agency is very good, staff are really efficient, professional and they use staff who really know how to provide care, as opposed to just going through the motions."

Another person said, "they are very good and have very high standard, I have been with them for years which says it all." A third person told us, "I would give them 12 out of 10, they have been completely reliable for years, and I have recommended them to others who now also find them far better than other agencies."

We undertook an inspection on 28 August 2012. The provider was not meeting one of the 'Essential Standards of Quality and Safety' regarding the care and welfare of people who use the service. The purpose of the inspection was to check that improvements had been made to ensure compliance with the essential standard. During our inspection we inspected four additional essential standards of quality and safety.

We spoke with five people and two relatives of people who used the service. The people we spoke with who used the service provided positive feedback regarding their experience of the service. Comments included 'the service is nothing short of exemplary” and “they are open and seek your views, decisions are respected”.

We viewed four care plans. The planning was centred on the individual and considered all aspects of their individual circumstances. There were arrangements in place that demonstrated that consent had been provided in relation to the care received.

Recruitment procedures protected people from the risk of being supported by unsuitable care staff because references had been fully checked.

We found that the provider had robust systems in place to regularly assess and monitor the quality of the services provided.

We found that the provider kept personalised care, treatment and support records secure and confidential for each person who used the service. Records were stored in a secure accessible way that allowed them to be located quickly.