Supreme Care Services Limited is a domiciliary care agency. The service provides personal care to people living in their own houses and flats. It provides a service to older adults some of whom have physical disabilities, mental health needs and are living with dementia. At the time of inspection 302 adults were receiving support with personal care from this service.

This inspection took place on 20 February and 1 March 2019 and was announced. 48 hours before the inspection we contacted the service to let them know that we will be coming to inspect them. We wanted to make sure that the management team would be available on the day of inspection.

This service has not previously been inspected.

The service had a registered manager who was on leave at the time of inspection. A registered manager is a person who has registered with the 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.

People and their relatives told us that communication with the agency staff was not always effective and that they found it difficult to get their enquiries answered in good time. We made a recommendation about this.

Staff followed the provider’s procedures if they noticed people being at risk to abuse or when incidents and accidents took place. There were appropriate risk management plans in place to mitigate the potential risks to people. Staff had to undertake appropriate checks before they were employed by the service. Staff helped people to manage their medicines where they required support to do so. Although systems were in place to encourage staff to adhere to infection control procedures, some staff had not always wore uniforms. People told us that covering staff had not always arrived for their calls on time and we found that the management team had made improvements in this area to address this concern.

People had healthcare professionals involved to guide staff on the support required to meet their health needs. People made choices about the food they wanted to eat. Staff were regularly supervised by their line manager and had support to discuss their professional goals. Systems were in place to monitor staffs training needs. However, some staff lacked knowledge about the Mental Capacity Act (MCA) 2005 principles and how this act was applied in practice.

People had complimented staff that supported them and described them as kind, caring and friendly. People told us they made choices about their care and support needs and that their views were listened to. Staff provided support that was respectful towards people’s privacy, culture and religion. Staff enhanced people’s independence and encouraged people to take part in the activities of their choice.

People’s care needs were assessed and staff were provided with sufficient level of information relating to people’s health conditions and day to day care needs. Where appropriate, care records included information about people’s end of life wishes. Systems were in place to gather people’s feedback about the service delivery. People had their communication needs identified and the support they required to understand information which helped staff to have conversations with people.

Systems were in place to monitor the care being delivered for people and actions were taken to improve where necessary. The staff team were regularly reminded of what was required of them in their role and took responsibility for providing good care for people. Staff were encouraged to socialise with people to address the issue of social isolation.