About the service:

Angels Care Management Ltd provides personal care to people living in their own homes in the community. At the time of the inspection the service was supporting 108 people.

People’s experience of using this service:

People's care plans were not always up to date regarding their individual needs and preferences. Care records were not clear, contained contradictions and mistakes. We saw improvements during this inspection.

Quality monitoring systems included audits, observation of staff practice and contact with people either face to face, through questionnaires or phone calls to check they were happy with the service provided. However, audits were not in place to identify the areas of concern we raised on inspection. People, their relatives and care staff said staff, the provider, registered manager and officer staff were approachable, organised, and ran the service well. We have made a recommendation around auditing and quality monitoring of the service.

People were supported by staff that were caring, compassionate and treated them with dignity and respect. People received support based on their individual needs and preferences. Staff knew what was important to people and people said they had a good rapport with staff, who listened to them and respected their wishes.

Staff had the skills and knowledge necessary to meet people’s needs. Staff felt confident in their role and they said they were supported by the management team. Staff were observant noticing and responding to changes in people’s health and well-being. They liaised appropriately with health professionals and followed their advice.

Staff were professional and competent; people and relatives said the service was safe. Staff demonstrated a good awareness of each person's safety and how to minimise risks for them. Staffing arrangements were consistent and reliable.

People, relatives and staff gave us positive feedback about the quality of people's care. They described the service as well managed and were confident if they had a complaint it would be acted upon.

Rating at last inspection: Good. Last report published 26 July 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection, the service was rated Requires Improvement overall.

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We inspected this service on 14 June 2016. This was an announced inspection and we telephoned the week prior to our inspection in order to arrange home visits and telephone interviews with people. Our last inspection took place in August 2014 and at this time the provider was meeting all our regulatory standards. The service provides care in people’s homes to older people and people with debilitating illness and long term conditions such as dementia. The service is available in the Long Eaton and surrounding areas. At the time of the inspection 119 people were being supported by the service, of which a majority received four calls a day to support them to remain in their own homes.

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 2008 and associated Regulations about how the service is run.

Care plans which were available in peoples home had not been updated to reflect any changes in the person’s needs following a review or changes in the person’s health.. Staff told us they used this information, we could not be sure any new staff supporting a person had the relevant information to enable them to provide the appropriate support required.

People told us they felt safe and we saw a range of risk assessments to ensure people were protected from harm. When people required support with their medicine, this was completed safely.

The provider and manager had a system in place to ensure there were sufficient staff to meet people needs, before they took on a care package. There were effective pre-employment checks of staff in place and effective supervision to support staff in their role. Staff confirmed they were well supported. We found staff were trained in a range of areas to enable them to support people’s needs.

People who used the service and relatives had confidence in the ability of staff to ensure people were safe. Staff had a good knowledge of people's likes, dislikes and people we spoke with felt they had a good relationship with the staff.

We saw that staff obtained people consent before they supported them and gave them choices in their daily life to enable them to remain as independent as they wished.

People's changing needs were identified and the service responded flexibly to peoples requests. Any requirement to support people with their health care had been accommodated and supported.

Any complaints which had been raised had been responded to and in line with the policy.

We saw the registered manager had in place a range of audits to identify areas of improvement to maintain the quality of the service.