About the service:

All About Care is a domiciliary care agency that was providing a service to 38 people at the time of the inspection. 28 of these people received care which was regulated by CQC.

People’s experience of using this service:

People who received care from All About Care told us they felt safe and supported by staff who visited them. Staff were punctual and consistent at carrying out visits with people in a person-centred manner. One person told us, “I would always recommend All About Care. All of the staff are lovely. The way they care for people is superb.” People were supported to continue living at home in a way that enabled them to be as independent as possible.

The manager had not ensured that certain areas of the service were always safe. We found that medicines were not always managed safely because records were not always correct. At the time of the inspection the manager did not have a plan in place in case of an emergency to ensure people would continue to receive care. The manager needed to obtain further information in order to be fully compliant with the Mental Capacity Act (MCA) 2005.

Although there was evidence the service had provided good end of life care, there was no information in care plans about people’s preferences for their end of life care. Following the inspection, the manager arranged for people’s preferences to be recorded in their care plans.

The service was not always well managed as some records and documents had not been completed. The manager had failed to implement robust or sufficient quality assurance processes. We also found that the manager did not have an adequate plan for improvement and development of the service. However, staff and people we spoke to all felt that the service was well led. People, staff and relatives were involved in helping the service improve.

Care plans were created with people and relatives’ involvement to ensure they were person centred and tailored to peoples’ needs and routines. Staff were trained and supported to be effective carers in a collaborative team. Where needed, staff were quick to support people to have access to health care professionals such as occupational therapists or, when necessary, emergency services.

People and relatives described staff as caring and kind towards them. Staff were approachable and friendly with people they cared for and knew them well.

More information can be seen in the main body of the report for each Key Question.

Rating at last inspection:

Good (14 June 2016)

Why we inspected:

This was a scheduled comprehensive inspection. We inspect all services rated as 'Good' within 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive.

Follow up:

Following on from the inspection the registered manager responded to the concerns we raised regarding medicines records, contingency plans, compliance with the MCA, end of life care preferences, audits and management plans.

This was an announced inspection that took place on 15 June 2016.

This is a domiciliary care agency that provides care and support to enable people to live as independently as possible in their own homes. It is located in the Guildford area.

There was a registered manager in post. 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.

At the previous inspection on 15 January 2014, the agency was compliant with the standards inspected. At this inspection the regulations were met.

People told us they were very happy with the service provided. The designated tasks were carried out to their satisfaction, they felt safe and the staff team and organisation really cared. They thought the service provided was safe, effective, caring, responsive and well led.

The records were kept up to date and covered all aspects of the care and support people received, their choices, their identified needs and if they were met. Care records contained clearly recorded, fully completed, and regularly reviewed information that enabled staff to perform their duties well.

Staff knew the people they gave support to and where aware of the way people liked to be supported. They worked well as a team and provided care and support in a professional, friendly and effective way. This was focussed on the individual and staff had appropriate skills to do so. They were well trained, knowledgeable and accessible to people using the service and their relatives.

Staff said they enjoyed their work and that the organisation was a good one to work for. They had access to good training that enabled them to carry out their tasks and received the support they needed from the manager.

People and their relatives were encouraged to discuss health and other needs with staff and had agreed information passed on to GP’s and other community based health professionals, as appropriate. Staff protected people from nutrition and hydration associated risks by giving advice about healthy food options and balanced diets whilst still providing meals that people enjoyed.

The agency staff knew about the Mental Capacity Act and their responsibilities regarding it.

People told us the manager was approachable, responsive, encouraged feedback and frequently monitored and assessed the quality of the service provided.

People told us they were treated with dignity and respect. We telephoned two people using the service and one relative of a person using the service to obtain their views on the service. One person told us that the “carers were outstanding, always bright and cheerful and had the right attitude”.

In the four care records we sampled, we found that people were enabled to make or participate in making decisions about their care. One person told us “the staff really have been invaluable and go the extra mile” and explained how important this was for them.

The provider showed us how they regularly assessed reviewed and monitored the quality of care it provided to identify and manage risks related to the health, welfare and safety of the people using the service. The manager said they were in regular contact with people using the service/and or their relatives and feedback was responded to promptly.

The provider protected people from abuse or the risk of abuse. We spoke with two staff and the manager and found they were knowledgeable about safeguarding adults and in accessing the local authority safeguarding policies and procedures.

The provider had effective recruitment and selection procedures in place. The four staff records we sampled evidenced staff were skilled and experienced in providing the level of care required. All required pre-employment checks had been completed prior to staff commencing work. Staff confirmed to us they had regular supervision.