This inspection was carried out on the 10 and 11 January 2018.

Allenby Douglas Ltd is a family run domiciliary care agency that provides personal care and support to people living in their own homes. It provides a service to older adults some of whom are living with dementia and younger disabled adults. Not everyone using Allenby Douglas Ltd receives a regulated activity. CQC only inspects the service received by people provided with ‘personal care’: for example, help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection 73 people were receiving personal care.

There was a registered manager in post who was present during our inspection. 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.

At the last inspection, the service was rated Good overall with Outstanding in the Caring key question. At this inspection we found that the provider had further developed the service and was now rated Outstanding overall.

People continued to receive a service which was highly caring. People and their relatives found staff to be extremely caring and kind. Relatives described the care and support their family members received at the end of their life as exceptional. People and their relatives felt staff often went ‘above and beyond’ what they expected of them.

The provider took care to ensure staff were compatible with people they supported to promote positive working relationships. People, and where appropriate their relatives, were fully involved in decisions about their care and felt listened to. Staff provided information to people in a way they could understand to enable them to make decisions for themselves.

Staff treated people with the utmost dignity and respect and supported them to remain as independent as possible to enable them to continue living in their own homes. People were supported to follow their interests and to maintain links with family and the local community.

People’s received care and support that was personal to them and took into account their preferences and wishes. People were supported by staff that knew them very well, who worked flexibly and were able to respond to changes in their needs in a timely manner. Staff knew about people’s personal histories and what was important to them, therefore care was tailored to meet their needs.

The provider and registered manager had a clear vision for the service that was shared by staff and management alike.

People were supported by highly motivated staff who were passionate about their roles and making a difference to people’s lives. Staff enjoyed a positive working culture and were involved in developments within the service. Staff felt well supported and valued by the management team and colleagues.

The registered manager and provider were committed to delivering excellent quality care and had a range of checks in place to monitor the quality and safety of the service. They used their findings to make continual improvements to the service, for the benefit of people who used it.

The registered manager and provider actively sought ways of engaging with the community. They worked with partner agencies to ensure current practice and effective care.

People felt safe and comfortable with the care and support provided by staff. People continued to be protected from the risk of abuse and avoidable harm by staff who were knowledgeable about the different types of abuse and knew how to report concerns of abuse or poor practice. Risks associated with people’s needs and their environment were assessed and staff followed guidance put in place in order to minimise these.

People were supported

The inspection was carried out on 14 October 2015 and was announced.

Allenby Douglas Limited is a family run domiciliary care agency that provides personal care and support to people in their own homes. At the time of our visit the agency was providing a service to 80 people. The frequency of visits ranged from one visit per week to four visits per day and they also provided overnight care where needed.

There was a registered manager in post who was present during the inspection. 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 extremely positive about the support they received. They told us they received support from staff who were caring, helpful and kind. Staff were highly motivated and treated people with dignity and respect. People were supported to remain as independent as possible. People were encouraged to maintain contact with people who were important to them and to attend social events

People benefitted from a flexible service that was responsive to their changing needs. People were able to make changes to their care visits as and when required and additional care was provided in a timely manner when people were unwell

People felt safe and comfortable with the staff and the support they provided. They took comfort from receiving support from the same care staff who would let them know if they were going to be late. Staff knew how to keep people safe from harm and abuse.

There were enough staff to ensure people’s needs were met. The provider had completed checks on new workers to ensure that they were safe and suitable to provide care to people who used the service.

People received support from staff who received training and support relevant to their role. Staff felt well supported by management who provided regular guidance and support to develop their skills and knowledge.

Staff sought people’s consent before supporting them and encouraged people to make decisions for themselves. Where people refused support this was respected. Where people had difficulty communicating verbally staff would look for other forms of communication such as body language, gestures or writing things down for people.

People received a personalised service which was tailored to their individual needs and preferences. People’s care plans were kept under regular review and people were actively encouraged to give feedback on the quality of the service. The provider had a complaints process and complaints were thoroughly investigated and action taken to prevent re occurrence.

The registered manager and provider were very committed to delivering a quality service and had systems in place to check on the quality of the service. They actively sought feedback from people relatives, staff and health care professionals in order to develop and improve the service.

The service had a positive working culture with open and honest communication. Staff took pride in working for the service and were highly motivated to deliver the values of the service.