About the service:

Supreme Homecare is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection it was providing care to 15 people.

Not everyone using Supreme Homecare receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People's experience of using this service:

People were safe in their home and there were enough staff to fulfil the visits to people.

People received the medicines they needed safely.

Staff understood their responsibilities about keeping people safe.

Risks were identified and managed well. Incidents and accidents were monitored to inform practice and make improvements to the service.

Staff understood their responsibilities to prevent the spread of infection whilst working between people's homes.

Staff had received the training and support they needed to carry out their roles well. People had confidence in the staff and were content with the care they received.

Care plan information focused on a person-centred method of supporting people. Information contained what support was required and care plans had been signed by people who received a service from Supreme Homecare.

Where appropriate, people received the support they needed to have a healthy diet.

People were supported to access health care services when they needed to. Staff described positive working relationships with health care professionals.

Staff supported people to remain independent and promoted their dignity. People's privacy was respected, and their personal information was kept securely.

There was a clear management structure that supported staff well.

Governance arrangements were embedded within practice. Regular audits identified any shortfalls in provision of care.

More information is in the full report.

Rating at last inspection: Good (published 1 April 2016).

Why we inspected:

This was a scheduled inspection based on the previous ratings.

Follow up:

We will continue to monitor the service through the information we receive.

We undertook an announced inspection on 16 February 2016.We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available at the office.

The provider registered this service with us to provide personal care to people who live in their own home. At the time of our inspection 30 people received care and support services in their own home. Services provided are for adults who may have a range of needs which include end of life care, complex health conditions which include physical disabilities and dementia.

At the time of our inspection a registered manager was in post. 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 told us they felt safe with all of the staff who provided care and supported them in their homes. There were arrangements in place to make sure there were sufficient staff employed who understood the need to protect people from the risk of harm and abuse The registered manager had taken measures to reduce risks to people’s safety. Staff were trained in how to recognise abuse and understood the action they should take if they had any concerns people were at risk of harm. The registered manager checked staff’s suitability to deliver personal care in people’s own homes during the recruitment process.

People’s care plans included risk assessments for their health and wellbeing and explained the actions staff should take to reduce the identified risks. Staff understood people’s needs and abilities by working alongside experienced staff when they started working at the service, speaking with people about their needs and reading care plans.

The registered manager assessed risks in each individual person’s home and advised staff of the actions they should take to reduce the risks. Where people needed support to take their medicines these were administered by staff who had been trained to do so. The registered manager had procedures in place to check people received their medicines as prescribed, in accordance with their health needs.

Staff received training and support which supported them to meet people’s needs effectively. Staff had opportunities to reflect on and improve their practice for the benefit of providing people with care and support to effectively meet their care needs.

People and relatives told us they were always asked for their consent before staff provided care and support to them in their homes. When people did not have the capacity to consent to their care the registered manager had arrangements in place so people’s rights were upheld and staff worked within the requirements of the law.

People told us that they were happy with the way in which staff helped them with their meals and in accessing health care services when they needed them to get the best outcomes for people’s health and well-being.

The registered manager asked people about their preferences for care during their initial assessment of needs. Staff supported the same people regularly so they learnt about people’s likes, dislikes and preferences for care. The registered manager regularly delivered care and support, so they maintained an on-going relationship with each person.

People told us the staff who provided care and supported them in their homes were kind and respected their privacy, dignity and independence and said staff felt like their friends. People knew any concerns would be listened to and action taken to resolve any issues. Records showed the registered manager learnt from complaints and adopted policies to reduce the risk of similar complaints in the futur

When we carried out our inspection of the agency it was providing personal care for 11 adults in their own home. During this inspection we spoke with the registered manager and nominated individual. Following our inspection we spoke with three people who used the service and one relative on the telephone. In addition we spoke with two members of staff who visited people to provide care.

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. They told us that the staff arrived on time and stayed for the agreed length of time. Comments included: “I’m treated nicely and listened to” and: "No question, they are 100% OK".

People told us they were happy with the staff and that they knew how to care for them. One person told us that: "They always know how to care for me”. Staff we spoke with told us that they had received training and support before they started work at the agency. One staff member told us: “I have good support here and feel happy in my work”.

The provider was able to demonstrate that they listened to people who used the service and regularly reviewed and monitored the care to make sure people received appropriate care.

We carried out a themed inspection looking at the services provided by domiciliary care agencies. As part of this programme of targeted inspection we asked people to tell us what it was like to receive services from this agency. The inspection was led by a Care Quality Commission inspector and involved using a person who has had direct experience of using the services of a domiciliary care agency. This ‘expert by experience’ took part in telephone surveys of people using this agency and their findings were incorporated into this report.

We were able to speak on the telephone with two people who received a service from Supreme Home Care Redditch and Bromsgrove and a relative who provided feedback on behalf of another person. We also visited three people at home who received a service to ask them for their views about the standard of care they received. During the visits we also spoke with a relative in person.

People told us that they had been personally introduced to their care worker before their service had commenced. They said they felt reassured by this.

The people we visited at home told us they were satisfied with the service and that care workers were reliable and turned up on time. They confirmed that the support they received had been agreed with them beforehand. They said that care workers were helpful and respectful towards them. Comments we received from people were positive and included:

“I am more than satisfied, they are fantastic.”

“We decided when we wanted carers to come in.”

“They go beyond what is expected of them.”

We found that the agency had satisfactory systems in place to plan, deliver and evaluate the care they provided.