The inspection took place on the 27 November 2017 and was announced. The inspection was conducted by two inspectors. At our previous inspection in October 2016 we found the service to be in breach of Regulation 12 Safe Care and Treatment and Regulation 9 Person Centred Care of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found improvements had been made and the service was no longer in breach.

Summercare Head Office is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and supported living houses. At the time of our inspection there were 70 people using the service.

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.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. People were supported to take their medication by trained staff.

People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005. 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 support this practice.

People had sufficient amounts to eat and drink to ensure that their dietary and nutritional needs were met. The service worked well with other professionals to ensure that people's health needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals.

Staff were well trained and attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.

People were provided with the opportunity to participate in activities which interested them at the service. These activities were diverse to meet people’s social needs. People knew how to make a complaint should they need to. When needed people were provided with the appropriate care and support at the end of their life.

The registered manager had a number of ways of gathering people’s views, staff held regular meetings with people and their relatives and used questionnaires to gain feedback. The registered manager carried out quality monitoring to help ensure the service was running effectively and to make continual improvements.

The inspection was announced and took place on the 11, 12 and 13 October 2016. Summercare Head office is a domiciliary care agency who provide personal care, domestic support and companionship to people in their own home as well as to people living in supported accommodation. At the time of our inspection 148 people were receiving home care support and 24 people were living in supported accommodation.

The service has 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.

Risk assessments had not been developed for all areas of identified risk. Care plans were not detailed and did not describe people’s preferences for care. Suitable arrangements were needed to ensure that staff received regular formal supervision and an annual appraisal of their overall performance. Although systems were in place to regularly assess and monitor the quality of the service provided, further improvements were required as they had not highlighted the areas of concern we had identified.

Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Staff supported people with their medication as required.

Staff had received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care. The service worked well with other professionals to ensure that people's health needs were met. Where appropriate, support and guidance were sought from health care professionals, including GPs. People were supported with their nutrition and hydration needs.

People told us staff were kind and caring. People were supported with activities which interested them. People and their representatives knew how to make a complaint; complaints had been resolved efficiently and quickly.

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SummerCare-Head Office is a domiciliary care service that provides care and support to people in their own homes who receive support for fixed periods of time during the day. In addition the service supports some people who live in supported living services, either on their own or with a small group of people, who receive 24-hour-a-day care and support. At the time of our inspection the service supported approximately 189 people, of whom 24 lived in supported living settings.

The service is provided to older people, people with dementia, people with a learning disability, people with a physical disability and people with mental health needs. At the time of our inspection approximately 189 people used the service, including 24 people who lived in supported living services. There is a registered manager in the service.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are a code of practice to supplement the main MCA 2005 code of practice. We looked at whether the service was applying DoLS appropriately and found they were meeting the requirements of the code.

There were systems in place to provide safe care for people who used the service. Feedback from relatives was positive and they were confident that their family members were safe.

The service ensured staff were supported to develop the skills and knowledge to provide effective care and support for people who used the service. Relatives were complimentary about the care and support provided for their family members.

People were supported by staff who displayed empathy and a caring attitude towards them. Relatives made positive comments about how caring staff were.

The service was led by a strong, effective management team who worked together to provide a service that received praise from relatives about the standard of care and support.

As the provider offers both a supported living service and a domiciliary care service we talked with people using both services. For the domiciliary care service we spoke with people and looked at records for people funded by both local authorities in order to ensure consistency in the service provided. On the day of our inspection 173 people were using the service, we attempted to speak with 20% of these and were able to speak with 14 people. We spoke with one person who had an advocacy role, one next of kin and six members of staff.

People's comments about the service were generally positive. Comments included; "I've got some real good carer's," "They're very good the girls that come, but I'd like a bit more help from them. I have to clear up after them." When asked how staff spoke to them one person told us that staff speak to them, "in a nice way." Another told us the way staff spoke was, "not nasty."

People we spoke to face to face appeared to have a good relationship with staff and spoke about them in a very positive way. People told us that they felt safe with staff.

On the day of our inspection we found that issues were dealt with in a timely manner. Staff told us the provider tries to ensure for the supported living service that there is consistency with staff. We saw that information kept by on call managers ensures that where cover is required for domiciliary care services staff are allocated according to need and risk.

Records viewed showed that support plans included the level of support required, the number of staff required to provide support each visit, the length of time for each visit and additional duties and tasks to be undertaken.

We spoke with four people who live within a supported living scheme. People told us that they were satisfied with the care and support which had been provided. We also spoke with two relatives of people who receive a service (supported living and homecare) and one person who currently receives personal care. Comments about the agency were noted to be variable. One person told us that they found the care and support provided for their member of family to be "excellent" and "second to none." One person spoken with told us that they had been "very dissatisfied" with the care and support provided for their relative.

Staff demonstrated a good understanding and awareness of how to respond and raise concerns if there was suspicion of abuse. People were cared for by staff that were supported to deliver care and treatment safely and to an appropriate standard.

There were arrangements in place to monitor and improve the quality and safety of the service.