About the service:

Action Homecare is a domiciliary care service. It is registered to provide personal care to people living in their own homes in the community, including older people and people living with dementia. The service operates in Long Sutton, Sutton Bridge and Holbeach. At the time of our inspection 66 people were receiving a personal care service.

People’s experience of using this service:

• People were at the heart of the service. Staff had a deep understanding of each person’s individual needs and preferences and used this knowledge to provide them with flexible, responsive support which enhanced the quality of their lives.

• People were closely involved in the development of their individual care plan and met with the provider on a regular basis to discuss and agree any changes.

• The provider had a meticulous approach to the deployment of staffing resources. This meant people experienced a high level of staffing continuity which had a very positive impact on their safety and well-being.

• Staff were caring and friendly and supported people with kindness and compassion in ways which often went far beyond the provider’s formal contractual agreement. People were treated with dignity and respect and were encouraged to retain their independence and exercise choice and control over their lives. End of life care was provided with sensitivity and compassion.

• The provider had established highly effective relationships with a wide range of health and social care services and went to considerable lengths to support people in maintaining their health and well-being.

• The registered manager demonstrated strong, inspirational leadership which was admired and appreciated by her team. The provider went to considerable lengths to promote the welfare and happiness of the staff team. Staff had the knowledge and skills to meet people’s needs and were encouraged to study for advanced qualifications.

• Without exception, people told us they were completely satisfied with the service they received and could think of no ways in which it could be improved. Any concerns were dealt with promptly and effectively and formal complaints were extremely rare. The provider maintained a range of auditing systems to monitor service delivery and ensure it remained in line with people’s needs and preferences.

• Systems were in place to identify organisational learning from significant incidents and the provider was committed to the continuous improvement of the service in the future.

• The provider assessed any potential risks to people and staff and put preventive measures in place to address them. People who needed staff assistance to take their medicines were supported safely and staff assisted people to eat and drink whenever this was required.

• Staff knew how to recognise and report any concerns to keep people safe from harm and were aware of people’s rights under the Mental Capacity Act 2005. 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.

• There was a registered manager ('the manager') at the service and the rating from our last inspection was displayed in the office. The manager was aware of the need to inform us of any significant events and incidents.

Rating at last inspection:

Good (Published May 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. At this inspection we were pleased to find service quality had been sustained in some areas and improved in others. As result the rating of the service is now Outstanding.

Follow up:

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

Action Homecare currently provides care for 52 people. We spoke with five people who received care from the service and three members of staff. We spoke with the provider who also managed the service.

All the people we spoke with were happy with the care they received. One person told us, “They are brilliant I have no complaints what so ever. They take their time with XXXX, to some extent they go over [the allotted time] as they are not prepared to not do a good job.” Another person said, “They are very good, very efficient.”

Staff told us they always wore protective equipment when they provided care to people, these included gloves, aprons and overshoes. All the people we spoke with told us the care workers followed infection control procedures. One person said, “They always wear gloves.”

The manager told us they tried to ensure there was continuity of care for people. People told us they normally had the same care worker visit them. One person told us, “They are not always swopping and changing staff, the girls[care workers] come regularly.”

The provider told us and records showed that they surveyed people in November 2013. We saw they had received 12 replies. Eleven replies rated the service as excellent, one rated the service as very good and commented, “No better care could you have.”

Action Homecare provides personal care services to older people and people with mental health needs living in their own homes in the Long Sutton, Sutton Bridge and Holbeach areas of South Lincolnshire. The service also provides domestic assistance such as cleaning and shopping although this service is not regulated by the Care Quality Commission (CQC).

We inspected the service on 25 February 2016. The inspection was announced. At the time of our inspection approximately 80 people were receiving a personal care service.

There was a registered manager in post at the time of our inspection. A registered manager (‘the manager’) is a person who has registered with CQC to manage the service. Like registered providers (‘the provider’), 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.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. Staff had received training in this area and demonstrated their understanding of how to support people who lacked the capacity to make some decisions for themselves.

People were at the heart of the service. Staff understood what was important to each person and worked closely with each other and other professionals to promote their well-being and happiness. People were actively involved in the preparation and review of their personal care plan.

Staffing resources were managed with great care to ensure that staff had time to meet each person’s care and support needs and to interact with them socially. People told us that staff were almost always on time and that calls were never missed.

The provider took a rigorous approach to staff recruitment to ensure new care staff had the right values to work in a caring and person-centred way. Staff had the knowledge and skills required to meet people’s individual needs effectively and were actively encouraged to study for advanced qualifications. The manager and her deputy provided staff with very close supervision and support, including direct observation of their care practice.

The provider went above and beyond the core homecare contract in a number of different ways. Parties were organised to give people a chance to meet each other socially and plans were in hand to establish a lunch club to further reduce people’s social isolation. Staff and volunteers encouraged people to retain an active presence in their local community and to maintain personal interests and hobbies.

The manager was known personally to everyone who used the service and provided staff with strong, values-led leadership. Staff worked together in a friendly and supportive way. They were proud to work for the service and felt listened to by the manager and provider.

The provider was committed to the continuous improvement of the service and maintained a range of auditing and monitoring systems to ensure the care provided reflected people’s needs and preferences. The provider sought people’s opinions on the quality of the service and encouraged people to raise any concerns or suggestions directly with the manager or other senior staff.

The provider assessed any potential risks to people and staff and put preventive measures in place where required. Staff knew how to recognise and report any concerns to keep people safe from harm.

People who needed staff assistance to take their medicines were supported safely and staff assisted people to eat and drink whenever this was required.