This inspection took place on 20, 21 and 22 August 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure the person who managed the service would be available. The inspection was undertaken by an adult social care inspector.

Adswad Ltd is a domiciliary care service. They are registered to provide personal care to people in their own homes. Although it also provided safe and well checks, support for medical appointments and befriending services which are not regulated by CQC. At the time of our inspection the service was supporting 14 people with a variety of care needs including older people and younger people with a disability. Care and support was co-ordinated from the services office which is based on the outskirts of Sheffield.

Adswad Ltd has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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 on-going 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.

The service has 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 2008 and associated Regulations about how the service is run.

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 schemes guided practice. People were involved and consulted about all aspects of their care and support, where they were able, including suggestions for activities.

Support workers we spoke with had a clear understanding of safeguarding people and they would act appropriately to safeguard people from abuse.

People's needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. We found the information contained in the care records we looked at was individualised and clearly identified people's needs and choices, as well as any risks associated with their care and the environment they lived in.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. We found some files required additional references. The registered manager confirmed to us after the inspection that all staff files had been checked and contained two references.

There was a programme of training, supervision and appraisal to support workers and office staff to support people using the schemes.

We observed good interactions between support workers and people who used the service. People were encouraged to make decisions about meals and involved in menu planning.

Complaints procedures were in place and the registered manager told us they were developing an easy read version for those that needed an alternative format.

There were effective systems in place to monitor and improve the quality of the service provided. We saw copies of checks undertaken by the registered manager and senior support worker at the service. The reports included any actions required and these were checked periodically to determine progress. We found some of the policies and procedures had not been reviewed or were missing. The regist

The inspection took place on 10 February 2016 with the provider being given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. The service was last inspected in April 2014 and was meeting all the regulations we looked at.

Adswad Limited is a domiciliary care service. They are registered to provide personal care to people in their own homes. Although it also provided safe and well checks, support for medical appointments and befriending services which are not regulated by CQC. At the time of our inspection the service was supporting people with a variety of care needs including older people, people living with dementia and mental health and younger people with a disability. Care and support was co-ordinated from the services office which is based on the outskirts of Sheffield.

At the time of our inspection there was a registered manager which manages the day to day operations of the service. 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 in their own homes and staff were available to offer support when needed to help them maintain their independence. All the people we spoke with told us the service they received was very good.

People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. We found the information contained in the care records we looked at was individualised and clearly identified people’s needs and choices, as well as any risks associated with their care and the environment they lived in.

We found people received a service that was based on their personal needs and wishes. People told us they were involved in their care reviews and if required their care package was amended to meet any change to their circumstances. Where people needed assistance taking their medication this was administered by staff that had been trained to carry out this role.

There was a recruitment system in place that helped the employer make safer recruitment decisions when employing new staff. The provider had recently employed more staff as they were expanding and we found the staff had received an induction and essential training at the beginning of their employment.

We found that staff we spoke with had an understanding of the legal requirements as required under the Mental Capacity Act (2005) Code of Practice. The Mental Capacity Act 2005 sets out how to act to support people who do not have the capacity to make some or all decisions about their care.

People were able to raise any concerns they may have had. We saw the service user guide that was given to people when they commenced using the service included information on how to make a complaint. People we spoke with were aware of how to raise any concerns, but told us they had none at the time of our inspection.

People were encouraged to give their views about the quality of the care provided to help drive up standards. Quality monitoring systems were in place and the registered manager had overall responsibility to ensure lessons were learned and action was taken to continuously improve the service.

The provider had a system to monitor the quality of the service provided. This was effective and identified areas for further improvement.

An inspection was undertaken to help us answer the following five questions;

Is the service safe? Is the service effective? Is the service caring?

Is the service responsive? Is the service well led?

Below is a summary of our findings. The summary is based on our observations during the inspection, speaking with people who used the service about their experience and talking to staff and the provider. We also reviewed documentation and records kept at the agency.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

The provider ensured people’s views and experiences were taken into account. People’s privacy and dignity was respected by staff to make sure people felt safe when they supported them. People who used the service were given appropriate information and support in a way they understood.

Support was delivered in a way that was intended to ensure people's safety.

The provider had made suitable arrangements by ensuring they were competent in identifying the possibility of abuse and the prevention of this so that people were protected from the risk of abuse and unlawful or excessive control or restraint.

Staff had received training on handling medication. The present duties consisted of staff prompting people to take their medication. The provider may find it useful to note that their medication policy was not (?)in line with the local authority policy to ensure consistency and therefore safety.

There were policies on recruitment and selection processes. The provider said they had not recruited staff in the recent months. However they told us that checks would be undertaken and only when satisfactory results were obtained would they allow staff to start working for the agency.

Is the service effective?

People who used the service understood the support choices available to them. The provider worked with the care managers of the individuals who were either social workers or nurses to inform people what care and support they were able to offer them. We saw documentation of people’s preferences in their care records.

We noted regular reviews had taken place to ensure the support was appropriate and effective. People and their relatives confirmed they were happy with the support they received.

Is the service caring?

We were informed by people who used the service and their relatives that staff respected their values and human rights when they delivered support. Staff said they had received training on valuing people’s diversity and protecting people’s human rights. One staff member told us that everyone should have the same rights and their mission was to make sure people received appropriate opportunities to ‘live a good life’.

Is the service responsive?

People were supported in promoting their independence and community involvement. Depending on the ability and preferences of people, staff offered them support with a variety of activities. One person told us that they were helped by the care worker to get involved in cooking and crafts.

There were recruitment and selection processes in place to ensure staff employed were fit for the role.

Is the service well-led?

Staff made sure they were trained and were able to gain necessary experience to meet the needs of people they delivered a service to.

The provider and staff worked closely with community workers and other professionals to ensure people received appropriate support. This was monitored each month and records kept by the provider.

This is a small service and people who used the service and relatives said they did not have formal surveys from the provider but they were able to give feedback about their satisfaction any time. People were satisfied with the support they received. Staff meetings were informal and the provider said they shared information with staff and made necessary improvements.

The service was not providing care services that require registration with CQC at the time of our inspection. The service was providing a support service to one person but this level of support was not required to be registered with us. Although the service was not providing care to anyone at the time of our inspection, they told us they were actively promoting their services to provide care.

We spoke with one person and the relative of the person who used the service. They told us the staff were friendly and polite. The relative said, "(The person using the service) gets on well with them, its brilliant really a real help."

We found that the provider did not have suitable arrangements in place to ensure that people who used the service were safeguarded against the risk of abuse. The service was non compliant with this outcome area.

The provider did not have a satisfactory recruitment and selection procedure in place to ensure that staff were appropriately employed. The service were non compliant with this outcome area.

We found that suitable arrangements were not in place to ensure that staff were receiving appropriate training to enable them to deliver care and treatment to service users safely and to an appropriate standard. The service were non compliant in this outcome area.

The provider had a system in place to deal with comments and complaints.