The inspection took place on 11, 12 and 16 July 2018. This is the first time we have inspected the service since it was registered in July 2017.

Sunderland Home Care Associates (20-22) is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults, some of whom are living with dementia. At the time of the inspection there were 167 people receiving a service.

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.

People and their relatives told us they felt safe receiving support from staff. Staff had completed training in safeguarding people and the service actively raised any safeguarding alerts with the local authority in a timely way.

Risks to people’s safety and wellbeing were assessed and managed. Environmental risk assessments were in place in relation to people’s own homes.

People’s medicines were administered in accordance with best practice and managed in a safe way. There were some ongoing issues with medicines administration records and work to improve these was ongoing.

People and relatives felt there were enough staff to meet people’s needs. The service used an electronic system to organise rotas and ensure enough staff were deployed to calls. Staff were recruited in a safe way with all necessary pre-employment checks carried out prior to starting work for the service.

New staff received a structured induction programme which included face-to-face training as well as shadowing shifts and assessments. All staff received regular training, supervisions and annual appraisals to support them in their roles.

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 were supported with their nutritional needs where required and to access a range of health professionals. Information of healthcare intervention was included in care records.

People and relatives felt the service was caring and staff were friendly. Staff treated people with dignity and respect when supporting them in their homes. People were supported to be as independent as possible.

People had access to advocacy services if they wished to receive support. Some people also had Lasting Power of Attorneys or relatives they appointed as advocates.

Care plans were in place for meeting each person's individual needs. They were personalised, detailed and included people’s preferences. Regular reviews were carried out with people about their care and support.

People and their relatives knew how to raise any concerns they had about the service. The provider had a complaints procedure in place and kept a log of any complaints received. All complaints received were investigated, acted upon and outcomes were fed back to complainants.

There were audit systems in place to monitor the quality and safety of the service. The views of people were sought by the service via questionnaires. All results were analysed and improvements were made, where identified. Any trends and lessons learnt were also recorded and acted upon.

The service worked in partnership with a number of agencies, including the local authority, safeguarding teams and multidisciplinary teams, to ensure people received joined up care and support.