About the service:

Audley Care Ltd - Audley Care Chalfont Dene is a domiciliary care service which provides support to people living in their own home. The office is located within the Audley Chalfont Dene retirement village. At the time of our inspection 25 people received assistance with the regulated activity of personal care. It supported people living in the retirement village and within the wider area of Slough and High Wycombe. Audley Care Ltd - Audley Care Chalfont Dene also supported people with non-regulated activities such as housework, laundry, social and shopping.

People’s experience of using this service:

People and their relatives gave us positive feedback about their experience. Comments included “As far as I'm concerned I'm well looked after. They are caring, thoughtful and respectful, they are like a friend to me,” “They are extremely caring, reliable and always on time I couldn't wish for better. They can't do enough for me,” “I have to say I think their care is exceptional, awesome,” “Yes, the carers are very kind to mum. Very polite and pleasant.” and “They’re very willing to help.”

People told us they had developed good working relationships with staff. Staff demonstrated a commitment to deliver a high-quality service. People were treated with dignity and respect.

People were supported by staff who had been recruited safely. Staff received initial training and on-going support to ensure they held the right skills and attributes to work with people.

People received a personalised service; each person had a care plan which was reviewed regularly to ensure it was accurate and up to date.

People were safeguarded from abuse. Staff were knowledgeable about how to recognise signs of abuse and had confidence to report any concerns.

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 service worked in partnership with other agencies such as healthcare professionals and the local authority. The registered manager kept their own learning up to date and attended local forums to share good practices.

The registered manager and provider had systems in place to monitor the quality of the service.

Rating at last inspection:

The previous inspection was carried out on 16 and 18 April 2018 (Published on 25 May 2018). The service was rated requires improvement at the time.

Why we inspected:

The inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. At the last inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. We asked the service to send us an action plan to detail how they intended to improve. At this inspection we found improvements had been made.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Inspections will be carried out to enable us to have an overview of the service, we will use information we receive to inform future inspections.

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

This inspection took place on 16 and 18 April 2018. It was an announced visit to the service.

Audley Care Ltd - Audley Care Chalfont Dene is a domiciliary care service which provides support to people living in their own home. The office is located with the Audley Chalfont Dene retirement village. At the time of our inspection fourteen people received the regulated activity of personal care, some of whom lived within the retirement village. The agency provided additional support to people. However the type of service provided did not need to be registered with the Care Quality Commission (CQC). For instance, support with shopping and social visits.

The service did not have had a registered manager in post at the time of 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. A new branch manager had been appointed and an application to register was in process.

We found medicines were not always management safely. The records relating to what medicine were required and when was not always accurate. We found gaps in medicine records as staff had not recorded they had given the prescribed medicine.

Providers and registered managers are required to notify us of certain incidents or events which have occurred during, or as a result of, the provision of care and support to people. One notifiable event is when abuse is suspected. The provider had notified the local authority of two allegation of abuse however they did not notify CQC.

The provider had clear processes for the management and supported expected to be given to staff. However we found gaps in the records relating to support staff were offered. We also received mixed feedback from staff on how regularly they were offered one-to-one meetings. We have made a recommendation about this in the report.

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. However we found assessments of people’s mental capacity to make a specific decision were made when they were not always required. We have asked the provider to ensure it supports people in line with the code of practice for the Mental Capacity Act 2005.

People told us they were happy with the level of support received comments from people included “They [Staff] are very nice people, caring in every way” and "They [Staff have made such a difference.” “Another person told us “They [Staff] really do care.” Throughout our inspection we observed staff treated people with kindness and respect.

People told us staff treated with them with dignity and respect. It was clear how staff spoke about the people they supported they enjoyed working with them. Staff were aware of how to protect people from abuse.

Staff told us they felt valued. There was a clear vision within the organisation and a commitment from the provider to drive improvements within the service. Risks were management effectively.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.