About the service:

Prolife Healthcare Services (known as Prolife) is a domiciliary care agency providing support for people living in their own homes and flats. Prolife provides services in Stockport and Trafford. At the time of the inspection Prolife were supporting 22 people.

People’s experience of using this service:

People and their relatives were positive about the care staff and the support they provided. They said that the staff knew their needs and the support they required. There had also been positive feedback from local authority social workers about the support provided by Prolife.

Where people required support with administering their medicines they received them as prescribed. Staff signed a medicines administration record (MAR) for all tablets. Where creams were applied this was noted in the daily records. Thickeners added to drinks to reduce the risk of choking were not always recorded in the daily logs. The registered manager said they would introduce staff signing a MAR for all creams and thickeners administered by care staff.

The support people needed was assessed and regularly reviewed with people and their relatives. Risks were identified and guidance provided for staff to minimise the known risks. The support to be provided at each visit was clearly documented in the care plans.

People said there had not been any missed visits and staff completed all tasks required. Staff also checked if people wanted any other things to be done during the visit. Some staff would collect some shopping or go to the post office on people’s behalf.

Staff had the training and support to carry out their roles. Staff said that they could contact the care co-ordinator or registered manager at any time and felt well supported. Staff had regular contact with the care co-ordinator and registered manager through phone calls, spot check visits and supervisions. Staff were safely recruited, with all pre-employment checks completed prior to the staff member starting work.

Matrices were used to track when care plan reviews were due and staff training needed to be refreshed. Care plans and staff training records were being uploaded to a computer based system which would highlight when reviews were due.

MARs and daily records were reviewed each month; however, the action taken if an issue had been identified was not always recorded. Incidents were recorded and reviewed by the registered manager. Any action taken was noted. A summary sheet for each person was used to identify if there were any patterns to the incidents.

A formal complaints procedure was in place, but few complaints had been received. People and relatives told us they would speak to the care staff directly or phone the care co-ordinator or registered manager directly if they had a concern. These were then addressed by the service.

Rating at last inspection: Good; report published 1 November 2016.

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

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

This was an announced inspection that took place on the 6 and 7 October 2016. The registered manager was not in the office during the inspection; we spoke with them by telephone on the 7 October. This was the first inspection after the service registered with the Care Quality Commission in April 2014.

Prolife Healthcare Services is registered to provide personal care to people in their own homes.

At the time of the inspection the service was providing personal care support for 23 people.

The service had a registered manager in place. 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. We also spoke with the nominated individual who was a director of the service. A nominated individual is a person employed as a director, manager or secretary of an organisation with responsibility for supervising the management of the regulated activity. The service had appointed a care co-ordinator in July 2016 to manage the rota, complete assessments and undertake quality spot checks on the service provided.

All the people we spoke with, and their relatives, said they felt safe supported by staff from Prolife Healthcare Services. Staff had received training in safeguarding vulnerable adults and knew the correct action to take if they suspected any abuse had occurred. Staff said the care co-ordinator, registered manager and nominated individual would listen to any concerns raised.

Where Prolife Healthcare Services had responsibility to administer people’s medicines they were administered safely. Medication Administration Records (MAR) were correctly completed and checked by the registered manager; however these checks were not recorded.

The service was working within the principles of the Mental Capacity Act (2005) (MCA). The local authority social workers assessed people’s needs and gained consent or completed best interest decisions for the support required before Prolife Healthcare Services were engaged to provide the support. People and their families, where appropriate, were involved in agreeing the support to be provided by the service.

Care plans and risk assessments were in place for each person who used the service. These gave guidance to staff on how to support people and mitigate the identified risks. The plans were reviewed every six months. A re-assessment was completed when people were discharged from hospital to record any changes in their needs.

A robust system of recruiting and training staff was in place. Staff completed mandatory training courses and undertook two shifts shadowing the care co-ordinator or registered manager before being placed on the rota. Training was refreshed on an annual basis.

Spot checks were completed by the care co-ordinator, registered manager or nominated individual every three months to observe staff practice. Supervisions were due to take place every six months; however we saw that this timescale was not always met. The care co-ordinator had started to complete supervisions with staff as well as the registered manager so these should be able to be held on a regular basis. Staff told us they felt well supported by the care co-ordinator and registered manager and they were always available by telephone if staff needed guidance or had a concern. This meant the staff had the skills, knowledge and support to provide effective care.

People who used the service and their relatives were complimentary about the staff at Prolife Healthcare Services. Staff had a clear understanding of people’s needs. Staff could explain how they delivered person centred care and respected people’s dignity and privacy. Staff supported people with their nutritional and health needs where applicable.

The care co-ordinator and regist