The inspection took place on 2 October 2018 and was announced.

Abbey Service (UK) Limited is a domiciliary care agency. It provides personal care to people living in their own homes in the community. Not everyone using the service receives a regulated activity; the 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.

The service was providing personal care to six people living in their own homes.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Staffing levels were sufficient to provide safe care and people were supported by a small and familiar staff team. Recruitment checks had ensured they were suitable to work with vulnerable adults.

People were protected from avoidable harm as staff received training and understood how to recognise signs of abuse and who to report this to if required. Risk assessments were undertaken and action taken to mitigate risks where necessary.

Medicines were managed safely. Staff were trained and were supplied with personal protective equipment (PPE) such as gloves and aprons.

People's needs continued to be assessed before they started using the service and were reviewed to develop their care plans. People received appropriate support by staff o meet their nutritional needs.

Staff asked for people’s consent before providing any care. Staff understood the principles of the Mental Capacity Act 2005 (MCA), however we found that the recording of information about people’s capacity needed to be clearer where best interest decisions had been made.

People and their relatives had been involved in assessments of care needs and had their choices and wishes were respected. The service worked well with professionals such as nurses, doctors, occupational therapists and social workers, to promote people’s health needs.

The service promoted a culture of dignified and respectful care. People told us that were supported by staff who were kind and caring. Close and effective relationship had developed between people and staff due to the small staff team.

Staff were trained and received ongoing support from the registered manager.

The provider had taken action to improve care plans and had included information which was person centred and contained details about people’s preferences, likes, interests and personal histories.

People received care and support that was personal to their needs and was responsive to their changing needs.

People had regular contact with the manager and reported no difficulties in raising any concerns about the service if necessary. However, people told us they had no reason to make any complaints.

People, their relatives and staff were positive about the way the service was managed. The service continued to monitor and assess the quality of the service they were providing to people.

Further information is in the detailed findings below.

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The inspection was announced and took place on 21 and 22 March 2016.

The service was last inspected on 13 May 2013 where it was found to be compliant in all the areas that we looked at.

Abbey Services (UK) Limited provides care and support to people aged 18 and over, older people, people with learning disabilities and people with physical disabilities in their own homes. The agency operates from premises close to the Wilmslow area of East Cheshire.

Abbey Services has a registered manager in post, who also provided personal care to people. 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. At the time of our inspection, they were providing personal care to six people.

The people who used the service and their relatives told us that they were treated with respect and kindness by the staff. Comments included, “The carers are excellent. They do everything that we ask for”, “they are caring and always tell me that I’ve only got to ask if there’s anything else they can do”. People told us that the staff had never missed a call.

The service had a one-time only password (OTP) token system in place that monitored calls. This token was kept within the care plan at the person’s house and the carers pressed this to generate a passcode which they then texted to the office where the start and end time of the call would be collated. If the carer was late, the office received an alert after 15 minutes. The office manager could then contact the person and the carer to find out why there was a delay and ensure that the person was safe. We saw this system in operation whilst we were conducting our inspection.

Travel time was factored into staff schedules and they had sufficient time to move between visits.

Arrangements were in place to protect people from the risk of abuse. We spoke to staff about their understanding of safeguarding and they knew what to do if they suspected that someone was at risk of abuse or they saw signs of abuse. Relatives of the people who used the service told us that they felt that their relatives were safe and supported by the staff of Abbey Services. Comments included, “I never worry about him when he is with the carers”, “they keep me informed of everything”.

We looked at recruitment files for the most recently appointed staff members to check that effective recruitment procedures had been completed. We found that appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.

The care files that we looked at contained the relevant information that staff needed to care for the person, however they lacked background history of the people who used the service and some details of their past. The manager acknowledged that this had not been recorded within the care plans and was in the process of reviewing all the care plans to ensure that this was included. However upon speaking with staff, they told us that they had an introductory visit with each person that they were supporting prior to starting work with them and they shadowed a number of shifts before starting work with each person and it was clear through the discussions that they knew the people they were supporting very well.

Discussions with staff members identified that they felt happy and supported in their roles. They told us that the registered manager was supportive and they felt that they could contact her and approach her at any time. Comments included, “I feel well supported and can contact Jackie at any time”, “the manager is approachable and very helpful”.

The service had a quality assurance system in place which used various checks and audit tools such as questionnaires and spot checks to monitor and review the practices w

We spoke to two people who used the service and their relatives. They all told us that they were happy with the care and support provided by the agency. One told us; "Good consistent care is provided." A relative told us; "My Mum is very happy with the care and they do more than we ever expected."

We looked at three care files and saw that they all contained person centred care plans and risk assessments to support people in the way that they wished to be cared for. We saw that care files were stored in both paper and electronic formats in the office. People who used the service had copies of their care plans in their homes.

We looked at policies and procedures relating to Safeguarding and Quality Assurance and saw that the agency had robust systems in place to monitor the care that they provided and to protect people who used their service. We saw that every person who used the service had been given a copy of the service user guide and the complaints procedure.