Attentive Care Experts is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection the service was providing care and support to 41 people.

At our last inspection 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 on-going 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.

The service had a registered manager in place. 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.

Staff understood how to keep people safe from harm. Recruitment procedures were thorough and there was a system in place to reduce the risk of late or missed calls. Medicines were managed safely and were only administered by staff who had received appropriate training.

The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005. 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 supported this practice.

The registered manager ensured staff had the skills and knowledge to enable them to meet people’s needs. This was achieved through a programme of induction, alongside regular training and management supervision.

People told us staff were caring and kind. People's rights to privacy and dignity were understood and promoted by staff. Choices were respected and staff encouraged people to retain their independence. Peoples care records were reflective of their needs.

People felt able to complain in the event they were unhappy with the service they received. There were effective quality assurance systems in place to monitor the quality of the service provided, understand the experiences of people who used the service and identify any concerns.

The inspection of Attentive Care Experts took place on 10 November 2015 and was announced one day before. This was to ensure there would be someone in the office on the day of inspection. The service had previously been inspected in January 2015 and was found to be compliant with the Health and Social Care Act 2008 Regulations at that time.

Attentive Care Experts operate in West Yorkshire providing a personal care service to 47 people living within their own homes. People’s needs include physical and mental health support and people receive up to four visits a day.

There was a registered manager in post on the day of inspection although they were on maternity leave. They did visit the office and spent time with us during the day. 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 we spoke with told us they felt safe and that the service was reliable as staff were punctual and carried out all the support tasks required. Staff demonstrated an in depth understanding of what may constitute signs of abuse and knew how to respond if they had concerns. The culture was open and staff were encouraged to raise any concerns about witnessed poor practice in a supported and protected environment.

We found that risk assessments were personalised and reflected specific needs, promoting independence as much as possible. People were supported by the same group of staff as far as possible ensuring consistency and valuable knowledge about individuals was gained.

Medicines were administered by appropriately trained staff who were aware of associated potential risks.

People and relatives expressed confidence in the staff supporting them saying it was evident they had received all necessary training and support. Staff demonstrated that they understood the Mental Capacity Act requirements through their knowledge of consent and best interest decision making.

Support was offered with nutrition in line with people’s specific needs and access to health and social care was arranged as necessary.

We were told by people using the services and their relatives that staff were kind, good and respectful. One relative said ‘they were attentive as in the name’.

The service was person-centred, flexible and swift to react to any concerns. This was enabled through real time record keeping on the electronic system, ensuring any missed tasks or late arrivals of care staff were flagged up and an alert raised.

We found the registered manager, even though officially on maternity leave, to be knowledgeable and very focused in driving forward an organisation that sought to provide high quality care with valued and rewarded staff.

During our last inspection on 10 and 17 January 2014 we had found the registered provider was not meeting this standard. This inspection showed that corrective action had been taken by the registered provider and the previous regulatory breaches had been remedied.

We reviewed the records which were kept at the registered provider's offices and looked at the way they were stored and managed.

Care records were seen to be in electronic and paper format. We were told electronic records were password protected and only accessible by people who needed access. Paper records were stored in lockable cabinets.

We looked at the manner in which verbal requests for changes to care were translated into a revised care plan. We saw records of verbal requests had been consistently replicated into current care plans.

We looked at three people's medical administration records. All records were complete with no gaps in care staff signatures.

We saw the registered provider maintained accurate records of financial interactions with people receiving care.

We inspected the provider's procedures and policy for archiving, disposal and storage of records. Our scrutiny of the policy showed the provider was adhering to requirements.

During the inspection we spoke with two people who used and service and six relatives. Everyone spoke very highly about the quality of care they received and nobody raised any concerns with us. People said staff arrived on time, stayed for the correct amount of time and completed all the required care tasks. People's comments included:

"Brilliant, very happy with them."

"They really care about her and understand her specific needs."

"Absolutely excellent, they were great in an emergency situation too."

"They have a good understanding of dementia care and provide good companionship, it takes the burden off me."

We found the provider had systems in place to ensure people who used the service were protected from the risk of abuse.

Systems were in place to ensure people received safe support in taking their medications.

Staff told us they felt well supported and we found a range of training was available to staff.

Arrangements were in place to monitor the quality of the service and ensure people's views were regularly sought.

However, we found care documentation required improvement. People's support plans and risk assessments did not always contain adequate or up-to-date information and medication administration records were not always filled out correctly.