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Inspection carried out on 27 November 2019

During a routine inspection

About the service

Head Office is a domiciliary care service. The service is registered to provide care and support for older people and younger adults who may live with dementia or physical impairments.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

At our previous inspection we found areas of improvement were required. This was in relation quality assurance systems and overall governance. At this inspection we found that improvements had been made. Additional governance systems had been introduced to help improve the quality of care and support provided.

People told us they felt safe and well cared for by staff. People were kept safe from harm as staff knew how to identify and report when people may be at risk of abuse. Risks to people’s safety and welfare were identified and actions taken to provide safe care that kept them safe. People’s medicines were safely managed and administered when required. Staff followed good practice guidelines to prevent the spread of infection.

Staff received training, supervision and support relevant to their role. Further development of training was ongoing. Where people required assistance with their nutritional needs staff supported them well. Systems were in place to ensure information to support people was shared and discussed appropriately with health professionals, where necessary. Consent to care was sought and staff understood people's rights to make their own decisions.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us they felt the staff were caring, kind and sensitive to their needs. People’s privacy and dignity was respected, and staff protected and promoted people’s confidentiality.

People's needs were assessed before they began to use the service and care plans were developed from this information. Care plans overall, contained information for staff to support people according to their needs. People and their relatives said they would be confident to raise concerns with the management team.

The provider had further developed governance systems which enabled them to have improved oversight of all aspects of the service. People, their relatives and staff members spoke highly of the registered manager and told us that they were always available and supportive. People were involved in the service development and staff felt able to raise their own views and opinions.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was Good (published 27 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 27 April 2017

During a routine inspection

This inspection was carried out on 27 and 28 April 2017 and was announced. This was the service's first inspection since registering with the Care Quality Commission in October 2016.

Head Office [Care 121 Services Ltd] provides personal care for people living in their own homes. At the time of the inspection five people were receiving a service from them.

The service did not have a manager who was registered with the Care Quality Commission (CQC). At the time of the inspection the previous manager had left and a new manager was in the process of registering. 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 and associated Regulations about how the service is run.

Prior to this inspection we had received information that suggested people were at risk of harm. When we inspected Head Office we found no evidence to support these concerns, however we found that further development was required in areas relating to management of the service.

People told us they felt safe and their individual risks were assessed and managed. There were sufficient staff available to meet people’s needs who had undergone rigorous employment checks prior to working in the service. People who required their medicines to be administered to them received these as the prescriber intended.

People were supported by staff who had received appropriate supervision and day to day support from the management team. People’s consent was sought before care was offered and the staff were familiar with the principles of the Mental Capacity Act 2005. People were supported to eat and drink enough to maintain a healthy diet and health professionals were contacted on people’s behalf if needed.

People told us they were treated with dignity and respect and were involved in planning and reviewing their care. Their confidentiality was promoted and records were held securely.

People received personalised care that met their needs and there was effective communication within the service to help ensure staff had up to date information. People were supported with interests important to them and staff amended their social interaction with people based on their individual needs. There had been no complaints to review but people knew who to speak with if they had a complaint.

There were systems in place to monitor the quality of the service however these at the time of inspection had not been effectively utilised. These were being developed further to support an increase in people who used the service when needed. People’s care records lacked detail about the person, and were not updated when people’s needs changed. People knew the manager and told us they felt the service was well run. Staff were very positive about the new manager and management team.