What life is like for people using this service:

Everyone we spoke with told us they thought the service received was good and supported them to maintain their independence. They spoke highly of the staff who cared for them and were proud that in some cases these professional relationships had gone on for many years, pointing out that staff knew them.

People told us they felt safe with the staff using the service. The service had safeguarding policies and procedures in place that staff knew and followed. People had risk assessments that highlighted any risks and how staff should work with them. When there were incidents and accidents these were recorded appropriately and discussed in team meetings. There were sufficient staff to provide care and all staff had been recruited with safety of people in mind. People were supported with prescribed medicines appropriately. Staff understood how to prevent infection and wore protective equipment where necessary.

People’s needs were assessed before they started with the service to assure their needs could be met. People were supported by staff who received an induction into their role and training how to do their jobs. Staff were supported through supervision and appraisal. Staff communicated people’s needs effectively with each other. Where necessary people were referred to healthcare professionals by staff. On occasion the service recommended adaptations to people’s homes to best support their needs. We checked whether the service was working within the principles of the Mental Capacity Act, the law that protects and empowers people who may lack the capacity to make their own decisions, and found that they were.

People were treated kindly and compassionately and staff had appropriate concern for their wellbeing. People were supported to express their views and make decisions about their care. People told us staff respected them and promoted their independence.

People had care plans that enabled staff to provide care that was responsive to people’s needs. Care plans were specific and personalised. Where possible, people were supported to do things they wanted to do. People knew how to make complaints and were comfortable doing so.

People told us the service was well managed.

Staff and people thought highly of the registered manager. Staff knew their roles and could align their values to that of the service. People and staff were engaged and involved in the service. There were adequate quality assurance measures in place. The service was well linked locally.

Rating at last inspection: Good – published on 21 April 2016.

About the service: Age UK Redbridge, Barking and Havering Ltd is a bathing and reablement service that is registered to provide personal care to people in their own houses. At the time of the inspection there were sixteen people using the service.

Why we inspected: This was a planned inspection based on the rating of the last inspection.

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

This inspection took place on 23 February 2016 and was announced. We gave the provider one day’s notice of our inspection.

Age Concern - Redbridge Daisy Fresh Service provides a domiciliary care service to people in their own homes. It is part of a wider organisation that provides a service to people who needed low level support to maintain their independence and continue living in their own homes.

At the time of our inspection approximately 85 people were using the service. The registered manager told us that 40 people received weekly support with bathing or showering from staff, employed by the service.

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 and associated Regulations about how the service is run.

The service had systems in place to reduce the risk of abuse and staff had undertaken training about safeguarding adults.

Systems were in place to minimise risk and to ensure that people were supported as safely as possible. However, the service did not always keep a record of when they had supported people with the application of prescribed creams. We recommend that the provider reviews their use of medicine administration records to ensure consistency with the Royal Pharmaceutical Society's guidance "The Handling of Medicines in Social Care." This is to ensure that people receive their prescribed medicine safely and appropriately.

The service employed enough staff to meet people’s needs. Appropriate staff recruitment procedures were in place.

Staff received the support and training they needed to give them the necessary skills and knowledge to meet people’s assessed needs.

People were able to consent to the care provided and make choices about their care.

People told us that staff treated them with dignity and respect and behaved in a caring manner.

People were actively involved in developing their care plans and in agreeing how they should be supported. Staff had a good understanding of people’s individual support needs.

People knew how to make a complaint and the service had a complaints procedure in place.

People and staff told us they found the registered manager to be approachable and accessible.

The registered manager monitored the quality of the service provided to ensure that people’s needs were met and that they received a safe and effective service.

People using the service experienced care that was planned and scheduled to meet their needs and mitigate any risks. Care was reviewed on a regular basis and could be modified when required. Records showed that the care delivered reflected the current care plan.

The provider had suitable procedures to manage emergencies and staff had the necessary training to do so.

Care plans and reviews were signed by people using the service to indicate agreement to the care that they received, and staff were trained to ensure people’s consent.

The provider had suitable and up to date policies and procedures in place to safeguard people using the service from harm or abuse and staff had received appropriate training in this regard.

Staff had appropriate training and support and had regular supervision and appraisals.

The provider had a variety of systems to monitor the quality of service provided and feedback from people using the service indicated a very high level of satisfaction with the care they received. People were contacted regularly to obtain feedback on their care. Appropriate policies were in place to assure and review health and safety of people using the service.

One person using the service told us, "They’re very good. Always on time and always respectful", while another said, "They’re lovely. I always feel very safe”.

People told us they were treated with respect and dignity by staff. One person said "they are polite and respectful. It's just so natural the way they act." We were told that people generally have the same regular carers, and that carers are punctual. We found that care plans and risk assessments were in place which set out how to meet people's needs in a safe way.

People told us if they had any concerns they would raise them with senior staff, and that they believed their concerns would be taken seriously. When asked if they felt safe one person replied "oh yes, I do." We found that staff had a good understanding of their responsibilities with regard to safeguarding vulnerable people. We found that the service carried out checks on staff before they started work, for example employment references and Criminal Records Bureau checks.

People told us that they were asked for their views on the service. One person said "I have spoken to the care coordinator of the service a few times, she asks if such and such is all right." We found that systems were in place for seeking the views of people on the service to help monitor and improve the quality of service given.

People were very positive and pleased with the bathing service provided by the agency. Most of them referred to the service as a lifeline and looked forward to the visits from the support workers. We spoke with some of the relatives and they echoed very similar sentiments about the service. One relative told us, “I have nothing bad to say about the service. They look after mum well, the staff are very nice and I could not wish for a better person to look after her”. Another relative told us: “We are very happy with the level of care mum receives from the bathing service. The lady rings if she has to change the day and is very gentle with mum. We would definitely use the other services on offer for mum”.

One person using the service told us: “I could not ask for better. The staff are very helpful, friendly, very good and make you feel comfortable while carrying out such a personal service. I am never embarrassed”. This person also told us that they were sent a form asking about the quality of the service, which they completed and returned to the office. Another person told us: “The staff are very good, kind and make you laugh. I am treated with dignity and respect and the girl always arrive on time. I have a care plan, which I sign and I am so happy with the service”. Other comments we received from people using the service included: “I am happy with the staff”, “The staff are pleasant and helpful”, “The staff are always on time”, “I have my bath on a Wednesday, which is exactly what I want” and “I have no problems with the agency”.

There was a high level of satisfaction with the service, which was provided by a small staff team. The service was valued for the personal side to it, which could be summed in one of the comments made by a relative. They stated: “I love the fact that Age Concern Redbridge Daisy Fresh Service can now offer the services they do, rather than an unknown large multi-care company with a different person coming to the home each time”.