This inspection took place on 18 December 2017.The service was last inspected in February 2016. At that time, the service was rated 'Good' across each of the five key questions. At this inspection we found the service remained Good.

Principle Support Limited is registered to provide personal care to adults with learning disabilities, autistic spectrum disorder, challenging behaviour and physical impairments and/or sensory impairments and older people in their own homes and community. The office is situated in the Handsworth area of Sheffield. Not everyone using Principle Support Limited receives the regulated activity, personal care. Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; which is 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 the inspection Principle Support Limited were supporting 8 people with regulated activity.

There was 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.

There were systems in place to protect people from harm, including how medicines were managed. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team.

Safe recruitment processes were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people.

People were supported in a kind caring way that took account of their individual needs and preferences. People and their families were supported to express their views and be involved in decisions about their care.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems supported this practice.

Staff were supported to provide appropriate care to people because they were trained, supervised and appraised. There was an induction, training and development programme, which supported staff to gain relevant knowledge and skills.

People received regular and ongoing health checks and support to attend appointments. They were supported to eat and drink enough to meet their needs and to make informed choices about what they ate.

The service was responsive to people’s needs and staff listened to what staff said. People could be confident that any concerns or complaints would be listened to and dealt with.

Systems were in place that continuously assessed and monitored the quality of the service.

This was an announced inspection carried out on 19 and 22 January 2016. The provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was previously inspected in February 2014, when no breaches of legal requirements were identified.

Principle Support Limited is registered to provide personal care to adults with learning disabilities, autistic spectrum disorder, challenging behaviour and physical impairments and/or sensory impairments and older people in their own homes and community. The office is situated in the Handsworth area of Sheffield. At the time of the inspection the service was being provided to 40 people. However only 10 people were receiving personal care. The remainder were being supported in leisure activities.

There is a registered manager which oversees services provided from the office. 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’s needs had been assessed before their care package commenced and relatives we spoke with told us they had been involved in formulating and updating their care plans. We found the information contained in the care records we sampled was individualised and clearly identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in.

We found people received a service that was based on their personal needs and wishes. Changes in people’s needs were identified and their care package amended to meet their assessed needs. Where people needed support taking their medication this was administered in a timely way by staff who had been trained to carry out this role. The service had clear medication policies to ensure staff could offer support to people safely.

People were able to take part in activities of their choice. Relatives we spoke with told us their family members had a very good social life and enjoyed taking part in a variety of activities. Staff also supported people to go on holidays of their choice.

People were able to plan their own meals and staff supported people to go shopping and prepare meals. One person we spoke with told us staff were able to give them advice on the best places to shop and how to eat a varied diet.

We found the service employed enough staff to meet the needs of the people being supported. This included support workers who visited people on a regular basis. People who used the service and the relatives we spoke with raised no concerns about how the service was staffed.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. We found staff had received a structured induction and essential training at the beginning of their employment. This had been followed by regular refresher training to update their knowledge and skills. Staff knew how to recognise and respond to abuse correctly. They had a clear understanding of the procedures in place to safeguard vulnerable people from abuse.

Staff told us they felt well supported and received an annual appraisal of their work performance. Staff had also received supervision sessions and spot checks to assess their capabilities and offer support.

The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected, including balancing autonomy and protection in relation to consent or refusal of care or treatment.

People were able to raise any concerns they ma

During our last inspection in June 2013 we issued compliance actions around respecting people using the service, gaining consent to care and monitoring the quality of service provision. We asked the provider to submit an action plan which would outline what improvements they would implement to meet the regulations. This was submitted within the set deadline.

During our most recent inspection we spoke with five members of staff, the manager, two people using the service and a relative of a person using the service.

A relative of a person using the service that we spoke with gave us positive feedback about the service. Some comments from included “I’m much happier now. The staff are much better, they are caring and carry out their jobs because they want to be there. It’s quite excellent. They go the extra mile.”

We found that people using the service and/or their relatives were asked for consent around their care.

We found that there were effective quality monitoring systems in place, such as complaints handling, incident reporting and auditing practice which ensured people received high quality care.

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke with the relatives of three people who used the service, looked at satisfaction survey responses collected in March 2013. We spoke with six members of staff. We reviewed six people’s care planning documents and four staff files.

During this inspection we followed up on a previous compliance action for outcome 16 and looked into some information of concern we had received.

Most of the relatives of people using the service that we spoke with gave us positive feedback about the service. We found that some people were not always treated with consideration and respect.

We found that people were not always asked for their consent about decisions around their care.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We found that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

We found that the provider did not have an effective system to regularly assess and monitor the quality of service that people receive.

People felt involved in their care. One person said, “My support worker involves me in my care. They are all very helpful.” Another person said, “The support workers are very caring and kind.”

We spoke with two people who used the service and three relatives of people who used the service. They told us that they were happy with the care and support they received. One person said “I always have the same carers. This helps me to get to know them.” People said that they were able to discuss anything about the service and anything they were not happy about with the staff. One person said, “I can talk to the carer about anything.”

People who used the service and their relatives told us that they felt safe and would speak to staff if they had any concerns. People were confident that any problems would be resolved.

Staff felt supported by the manager and the co-ordinator. They felt that training provided was of a high standard.

The provider did not have an effective system in place to regularly assess and monitor the quality of service that people received.