Anglian Care Limited provides personal care to people living in their own houses and flats and specialist housing. This service is a domiciliary care agency. It provides a service to older people.

The inspection was carried out between the 28 March 2018 and 8 June 2018. At the time of the inspection there were 45 people who used the service.

At our last inspection to the service in November and December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Our key findings across all the areas we inspected were as follows:

• Excellent arrangements were in place to assess and monitor the quality of the service provided. There was a positive culture within the service that was person-centred, open and inclusive. People received an outstanding quality service that was flexible and responsive to their needs. People’s and others views about the quality of the service provided was sought and acted upon.

• Suitable arrangements were in place to keep people safe. Policies and procedures were followed by staff to safeguard people and staff understood these measures. Risks to people were identified and managed to prevent people from receiving unsafe care and support. The service was appropriately staffed to meet the needs of the people using the service. People received their medication as prescribed and in a safe way. Recruitment procedures were followed to ensure the right staff were employed. People were protected by the provider’s arrangements for the prevention and control of infection. Arrangements were in place for learning and making improvements when things go wrong.

• Staff had a thorough induction to carry out their role and responsibilities effectively. Staff had the right competencies and skills to meet people’s needs and received regular training opportunities. Suitable arrangements were in place for staff to receive regular formal supervision. People’s nutritional and hydration needs were met and they were provided with drinks and snacks throughout the day. People received appropriate healthcare support as and when needed from a variety of professional services. The service worked together with other organisations to ensure people received coordinated care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

• People were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported.

• Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Information about how to make a complaint was available and people’s representatives told us they were confident to raise issues or concerns. No-one was currently receiving end of life care.

Anglian Care Limited provides care and support to 38 people who live in their own homes. Our inspection team was made up of one inspector. As part of this inspection we spoke with eight people who used the service, one relative, the registered manager and three care staff. We also reviewed records relating to the management of the service which included four care plans and four staff files.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us and the records we looked at.

Is the service safe?

There were detailed care and support plans for each person who used the service. Care plans had been reviewed. There was a phone number for emergencies out of hours and a plan in place in case of adverse weather. Care plans and risk assessments had been reviewed quarterly or sooner if a person's needs had changed.

There were effective recruitment processes in place and evidence staff had identity and character checks. Staff had received regular training updates.

A relative we spoke with told us, “My X feels safe with the staff, they are very kind.”

Is the service effective?

The service undertook assessments with the person who used the service or a relative to identify their support needs. The service was using the skills and knowledge of staff members to provide the required service to meet people's needs.

Staff had received regular supervisions and appraisal's and the staff we spoke with confirmed this. One person told us "I received regular supervision and training updates.” Staff we spoke with told us that the manager was very supportive and organised.

Is the service caring?

People who used the service or a relative had been involved in decisions about their care and support. Staff supported people and advised them, but allowed the person who used the service to make the final decision. A person who used the service told us, "They are very kind to me." Another person said, "The staff are absolutely wonderful, they treat me very well, polite and caring."

Is the service responsive?

The service liaised with other health professionals to meet the needs of people who used the service. People's individual needs had been assessed and staff were aware of their needs. One person who used the service told us, "Sometimes I need to change the time of a visit, the agency were able to arrange this for me." Another person said, "When I asked for an extra visit, they were able to start it the next day."

Is the service well-led?

There were processes to monitor and improve the quality of service delivery and the people who used the service had been provided with information about how to make a complaint. People we spoke with told us that they felt able to raise any concerns with the staff that visit them or with people in the office.

We visited three people at their homes with staff and we spoke with three people and a relative of a person using the service over the telephone, to gain their views on Anglian Care Limited. We spoke with nine staff including senior managers. We also reviewed the care planning files of four people and viewed four staff personnel files and other records relating to the management of the service.

People told us that the care was good and staff were reliable. One person said, “I’m very satisfied with the care I get.” Another person said, “I’ve no complaints.”

We found that there were systems for staff to cooperate with other providers and professionals regarding people's health and social care needs.

The provider had systems in place for the recruitment of staff, for monitoring and assessing the quality of the service.

Anglian Care Limited has office premises which were safe and suitable and we found that there were systems in place for ensuring that records were kept safe and secure.

We spoke with four people using the service and two relatives. They told us that the care was good and that staff gave them support. Comments about the service included, “We are very pleased.” “I can’t fault it at all.” “They are nice people.” “Excellent.”

We found that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We spoke with eight staff who told us that there were enough staff.

People and relatives told us they felt able to raise any concerns they had with staff.

People that use the service told us that the agency’s staff treated them well. They said that they were given good information about the service and that they had copies of it with their care and support plans. They told us that they had been and were fully involved in planning and reviewing their care and support. One person told us that all of the agency’s staff treated them with dignity and respect.

People told us that the manager had visited them prior to the service commencing and that he had fully explained all aspects of the care and support that the agency could provide. They said that the manager gave them detailed information about the cost of the service. They told us that staff were very reliable and that they let them know if they were delayed for any reason.

People said that they were happy with the care and support they received from Anglian Care. They told us that the staff were polite and helpful and that they carried out all of the tasks detailed in their care and support plans. They told us that they had a full assessment before their service started. They said that their care and support plans were regularly reviewed to ensure that they still met their needs.

People told us that they felt safe when they agency’s staff visited them. They said that they trusted them and felt comfortable when they were in their homes. People told us that the staff helped them with their medication. They said that they were happy with the way that they did it.

People told us that all of the carers that visit them were nice, they said that they always spoke respectfully to them and apologised and explained if they were late for any reason. They told us that the carers knew what they were doing and seemed to be very well trained.

People told us that they were often asked if the service they received was satisfactory. They said that the office checked to make sure that everything was alright and that they were getting the help that they needed.

This inspection took place on 24 November and 17 and 30 December 2015.

Anglian Care Limited is registered to provide personal care and support to people living in their own homes. At the time of our inspection there were 52 people using the service.

The service had a registered manager in post who is also the provider. 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 received excellent person centred flexible care in a way that ensured their safety and welfare and met their diverse needs and preferences. Staff had been safely recruited in sufficient numbers to meet people’s needs. They had been well trained and were fully supported to carry out their role safely.

Risks to people’s health and safety had been identified and there were plans in place to manage them. Staff knew how to protect people from the risk of harm and abuse, they had been trained and had access to guidance and information to support them with the process.

Medication management, where required was good. People received their medication as prescribed.

People were respected and treated with dignity. They said that they were listened to and that staff gave them the time they needed when providing them with care and support. People had been fully assessed and their care plans met their needs and preferences and informed the staff how to care for them safely. Where required, staff provided people with appropriate support with eating and drinking and maintaining their health.

The registered manager/provider and staff demonstrated a good understanding of the Mental Capacity Act (MCA) 2005.

People were cared for by staff that knew them well and were kind, caring and compassionate. Staff maintained people’s dignity and showed them respect at all times.

People knew how to raise a concern or complaint and were confident that any concerns would be listened to and acted upon.

People received an outstanding quality service that was flexible and responsive to their needs. The registered manager/provider had an excellent and effective quality monitoring system in place to drive improvements and to ensure that people received the best care possible.