TC Care - Premier House is a domiciliary care agency that provides personal care to around 70 people in their own homes.

At the last inspection in 2014, the service was rated Good but a breach had been identified during the inspection in relation to the management of medicines.

At this inspection the service remained good and improvements had been made in the management of medicines.

People told us they felt safe when they received support and the provider had policies and procedures in place to deal with any concerns that were raised about the care provided.

The provider had processes in place for the recording and investigation of incidents and accidents.

The provider had an effective recruitment process in place. Care workers had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers had regular supervision with their manager and received an annual appraisal.

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 we spoke with felt the care workers were caring and treated them with dignity and respect while providing care. Care plans identified the person’s cultural and religious needs.

Detailed assessments of the person’s needs were carried out before the person started to receive care in their own home. Each person had a care plan in place which described their support needs. Care workers completed a record of the care and support provided during each visit.

The provider had a complaints process in place and people knew what to do if they wished to raise any concerns.

The provider had systems in place to monitor the quality of the care provided and these provided appropriate information to identify issues with the quality of the service.

Further information is in the detailed findings below

We spoke with the provider's one of whom is the manager of the service, five other members of staff, 10 people who use the service and six relatives who had family members who were using the service at the time of our inspection. We saw in the care records we viewed that people or their relatives had been involved in developing support plans and signed their consent to the agreed care. People also told us that staff respected and supported their decision making in completing daily tasks.

People told us that they had regular staff who supported them and said they were happy with the service they received. One person said, “the carers are excellent, I can’t fault them”, whilst another person told us, “they [staff] are wonderful.” One relative we spoke with said, “the carers are superb.” We saw care plans that detailed people's needs including their likes, dislikes and preferences.

Staff demonstrated an awareness of their responsibilities with regard to protecting people from abuse and reporting any concerns they had about a person's welfare. Any safeguarding concerns were responded to appropriately and reported to the local authority safeguarding team.

We found that staff were well supported and received regular training, supervision and appraisal. Staff told us they all received one to one supervision, which we saw evidence of in the staff files that we viewed. Staff told us the managers were “always here for you” and that they were “approachable”.

There were effective quality monitoring systems in place to ensure that any areas for development were identified and addressed.

We talked with the manager of the service and two members of staff. We also spoke with two people who use the service and three relatives to find out about their experiences.

People told us that they were happy with the care they received and that they received care from the same members of staff who knew their needs. People were involved in their care and any decision making and encouraged to make choices and asked for their views about the service. People told us that staff treated them respectfully and one relative spoken with said when talking about the staff, “they are always respectful and I trust them”.

There are systems in place to ensure that people are protected from abuse and staff could demonstrate their knowledge of safeguarding and what action they would take if they had concerns about the welfare of someone they were providing care for.

We saw evidence of appropriate recruitment and selection processes. However, there was not always evidence that references had been verified and therefore the provider could not be assured that these references accurately reflected the staff members conduct in previous employment. The service had also not been asking for detailed employment histories from prospective staff members but this was in the process of being addressed.

People told us that they knew how to make a complaint and said that they felt able to raise any concerns that they had. There was a very low level of complaints recorded for the service.

We undertook an announced inspection of TC Care – Premier House on 28 and 29 July 2015. We told the provider two days before our visit that we would be coming because the location provided a domiciliary care service for people in their own homes and staff might be out visiting people.

TC Care – Premier House provided a range of services to people in their own home including personal care. At the time of our inspection 60 people were receiving personal care in their home. The care had either been funded by their local authority or people were paying for their own care.

We spoke with the people using the service, relatives and care workers to obtain feedback about the service provided.

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 and associated Regulations about how the service is run.

There was a policy and training in place in relation to medicines but the medicine administration record (MAR) charts did not provide the care workers with appropriate guidance on how medicines should be administered.

Assessments were carried out to identify each person’s care needs before they started to receive care in their home. This information was used to develop the support plan for the person.

The provider had systems in place to monitor the quality of the care provided and these provided appropriate information to identify issues with the quality of the service.

People using the service and relatives we spoke with told us they felt safe when care was provided by staff in their home. The provider had policies and procedures in place to respond to any concerns raised relating to the care provided.

The provider had processes in place for the recording and investigation of incidents and accidents. A range of risk assessments were in place in the support folders in relation to the care being provided.

Care workers had received training identified by the provider as mandatory to ensure they were providing appropriate and effective care for people using the service. Also care workers had regular supervision with their manager and received an annual appraisal.

People we spoke with felt the care workers were caring and treated them with dignity and respect while providing care. Support plans identified the person’s cultural and religious needs.

Care workers completed a record of the care and support provided during each visit.

There was a complaints process in place and people told us they knew who to contact at the office if they had a concern. Questionnaires were sent to people using the service every year and the registered manager was reviewing the format used to see if response rates could be improved.

We received mixed feedback from people when asked if they felt the service was effective and well-led with both positive and negative comments relating to when they contacted the office.

We found a breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to the management of medicines. You can see what action we told the provider to take at the back of the full version of this report.