Advance provides personal care for people living in their own homes. On the day the inspection the registered manager informed us that there was one person receiving a service from the agency.

A registered manager was in place. 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. The registered manager was also the provider.

Relatives we spoke with said they thought the agency ensured that their relative received safe personal care.

Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

Risk assessments were not fully detailed to assist staff to support people safely.

Staff had been safety recruited to ensure they were appropriate to supply personal care to people.

Staff had training to ensure they had the skills and knowledge to be able to meet people's needs.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choice about how they lived their lives.

Staff had awareness of a person's health care needs so they were in a position to refer to health care professionals if needed.

A relative we spoke with told us that the staff member he knew was friendly and caring.

The person had been involved in making decisions about how personal care was to be provided.

The care plan was individual to the person using the service, but more evidence was needed to evidence that the person’s individual needs were met.

Relatives told us they would tell staff or management if they had any concerns and but were not confident this would be comprehensively followed up.

Staff were satisfied with the support they received and how the service was run in the best interests of people receiving a service.

Management carried out audits to ensure the service was running properly.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

People told us they felt safe. The relative we spoke with also said they thought their relative had been safe with staff. People said that they felt their rights and dignity were respected by staff.

Staff had been aware about care plans and support plans had been written for people with particular needs. Plans contained sufficient detail to promote people's welfare.

Is the service effective?

People’s health and care needs had been assessed and care plans had been in place. There was evidence of people being involved in assessments of their needs and planning their care.

Specialist needs had been assessed and included in care plans.

Care plans had been reviewed to ensure people's changing needs had been met.

Is the service caring?

We spoke with two people. The people we spoke with told us that staff had supported them properly. One person said ‘’staff are good. They help me.’’

We saw evidence that people had been sent a satisfaction survey. This meant there was an opportunity for people to comment on the service provided and whether it was caring or not.

Is the service responsive?

We saw that reviews had been held to monitor any changing needs that people had.

People told us when they told staff about anything that had concerned them, this had been put right.

Is the service well-led?

Staff told us that if they witnessed or heard of poor practice they would report their concerns to their management.

The service had systems to check that services were of a good quality. We saw that staff had been spot checked to ensure care was meeting the needs of people. Staff received supervision to check their competence and provide them with support.

We received a comment that senior management did not always appreciate the work that support workers carried out to ensure people's needs were met. There had been a feeling that support workers had not always in the past been fully supported in their work. This aspect needs to be reviewed to see what processes are in place to ensure staff feel valued for their positive contributions to ensuring people's needs are met.

There were two people using the service at the time of our inspection visit. We spoke with one person on the telephone and asked them for their views about the service they received. They told us they had been supported by the service for several years and they spoke positively about the three members of staff (support workers) who supported them. They told us staff always turned up to provide their support. The person told us staff supported them to go out into the community, which included social activities including shopping. They also said they helped them to prepare meals and undertake household chores, and supported them with personal care in a limited capacity.

We spoke with three support workers who supported the two people who used the service. Support workers we spoke with had a good understanding as to their role in providing support and care to the two people who used the service. Information provided by the support workers as to the care and support people required was consistent with the information we had read in people’s care and support plans and other records.

We spoke with three support workers who gave a detailed account as to their role and responsibility in supporting people in a way which protected their rights. Support workers were aware that the people they supported were at risk of being abused or exploited due to their vulnerability and lifestyle choices. Staff told us they had received training and guidance as to what action they should take if they believed the person they were supporting was being abused or exploited.

People who used the service were given information about the services provided by Advance as well as information as to how they could become involved in developing and improving the service, through the services quality assurance system. People were encouraged and made aware of community meetings and events organised by Advance. Information provided to people was available in an easy read format, to help facilitate peoples understanding.