About the service: Audley Care Ltd - Audley Care St Elphins Park are based at St Elphin's Retirement Village. They provide personal care and support to people living in their own homes at St Elphin's Retirement Village and in the local community.

Not everyone using the service receives the regulated activity of personal care. CQC only inspects the personal care service provided to people, that is help with tasks related to personal hygiene and eating. Where personal care is provided to people we also take account of any wider social care provided. At the time of our inspection there were 29 people receiving personal care from the provider.

People’s experience of using this service:

People were safeguarded from the risk of abuse. Risks associated with people’s care and support had been identified and managed appropriately. The provider had a safe recruitment system in place. Staff told us they had enough time to support people. Medicines were managed in a safe way.

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.

Staff received training and support to carry out their role effectively. People received appropriate healthcare and were supported to maintain a balanced diet. People’s needs and choices were identified and respected.

We spoke with people who used the service who were very complimentary about the care and support they received. People confirmed that their privacy and dignity was maintained.

Care records were person-centred and reflected people’s needs and preferences. People were involved in their plans of care. The provider had a complaints procedure which people were aware of. People told us they felt at ease to raise concerns and felt they would be appropriately addressed.

Staff we spoke with knew their role and responsibilities and felt supported by the registered manager. People had opportunities to voice their opinions about the service. The provider had systems in place to ensure the service maintained the quality they expected.

Rating at last inspection: Good (report published 19 October 2016).

Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection.

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

This inspection took place on 29 June 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure someone would be in the office. The service provided domiciliary care and support to people living in Darley Dale in Derbyshire and also into St Elphins Extra Care Housing Scheme. At the time of our inspection there were 49 people using the service, 45 people living in the community and four living in St Elphins Extra Care Housing Scheme.

There was no registered manager at the service. However, the manager had applied for registration with the Care Quality Commission and this process was underway. 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 told us they felt safe with the staff team from Audley Care. Staff members had a good understanding of the various types of abuse and knew how to report any concerns.

People had consistent staff who supported them. People told us staff arrived on time but if they were running late for any reason they received a telephone call to inform them of this. Staff confirmed they had regular people they visited and had opportunities to talk to people on their visits.

People were supported by staff that had received appropriate training to assist them to meet people's needs. People were supported to take their medicines safely.

The manager and staff understood the principles of the Mental Capacity Act 2005 (MCA) and their responsibilities around this. People using the service told us that staff always obtained their consent before they provided their care and support. Staff members confirmed this and they were aware that people would communicate with them in different ways to give their consent.

Care staff had a good understanding of people's dietary needs. They were aware of people's food allergies and we found there was sufficient information about people's likes and dislikes with regard to food in their care plans. The staff team ensured that people's well-being was supported and maintained.

Staff members were kind and caring. Staff respected people's privacy and dignity and promoted their independence.

People contributed to an assessment of their needs and received care that met their needs and preferences.

People felt able to speak to the management and support staff at the service. They felt they were open and approachable. People felt able to raise concerns with the service and they were satisfied with the way the service responded to their concerns.

The staff team had an understanding of the purpose of the service and worked together to support the needs of people they visited.

The inspection was completed by a single adult social care inspector. At the time of this inspection the current registered manager was in the process of deregistering and a new manager was in the process of registering.

On the day of the inspection the service was being provided to 56 people. As part of the inspection we were following up on previous non-compliance relating to a quality audits not being completed and actions not been taken on findings of customer survey’s. As part of this inspection we spoke with seven people who used the service and two relatives. We spoke with the new manager and area manager. We looked at four care records and spoke with five care staff. We sampled staff records and reviewed records relating to the management of the service.

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. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

Risk assessments were in place for things such as moving and handling and more general issues such as the environment. Control measures had been put in place in risk management plans. This meant that people’s needs were met and people were kept safe. People and their relatives confirmed they felt the service was safe. One person said, “Yes I feel safe, I have no trouble they are very good.” A relative said, “The staff that go in are tremendous.”

Documented procedures were in place for the Mental Capacity Act 2005. We were not able to see any mental capacity assessments or best interest decisions on day the day of inspection. This was because the new manager told us that people had capacity. We saw that where people had power of attorneys this was recorded. Staff had an awareness of the Mental Capacity Act 2005 (MCA). Staff and records showed staff had received training in this. This meant that systems were in place to safeguard people as required.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff had been trained in safeguarding vulnerable adults and knew what to do in the event of suspected abuse.

Staff had received appropriate professional development and were able to obtain further relevant qualifications. Staff wore uniforms and carried identification badges so people could ensure people supporting them were employed by the provider. This meant people’s safety was maintained. One relative said, “Staff are nicely turned out and are caring.”

Is the service effective?

People experienced care and support that met their needs. People told us how they were supported. We saw that doctors had been contacted when people were unwell. People’s care was reviewed regularly. People’s views were gained when managers did quality checks on staff. This was confirmed by people and their relatives. This meant that people received care in the way they wanted.

We saw systems were in place to gain consent from people. People or their relatives had signed consent forms and risk assessments to demonstrate their agreement. Staff told us they sought people’s consent daily through asking them what they would like and how they would like things. This meant people received care in the way they wanted.

Regular audits were now taking place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people’s needs.

Is the service caring?

People were supported by friendly and considerate staff. Staff we spoke with told us how they supported people. People and relatives confirmed staff were caring, respectful and polite. One person said, “They are like family.” Another person said, “We are happy with the service.” A relative said, “The level of care we contracted is being delivered, they will go above when it is required with no complaints.”

Care and support had been provided in accordance with people’s wishes. People were involved in their day to day care and were supported to maintain their independence. Staff knew of people’s preferences, however, this was not always recorded in older care plans. New care plans were more personalised identifying people’s preferences. People’s religious and cultural beliefs were taken into account and recorded. This meant people’s diversity and individuality were promoted and respected.

Is the service responsive?

People were treated with respect and dignity. This was confirmed by people we spoke with. A relative said, “I am very happy they provide a standard I would expect.” Care plans had been developed and were reviewed regularly. People and relatives confirmed they were involved in changes to their care. Staff demonstrated a good understanding of people’s needs. People were given choices and supported to make decisions themselves. A relative said, “They are very good.”

People told us they would speak to the office if they were unhappy about anything. People were issued a ‘service user handbook’ that outlined the person’s rights and how the service would support them. Details of the complaints procedure was contained in the ‘service user handbook’. People and relatives told us they had no complaints and were confident that if they did they would be listened to.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. This was confirmed by people we spoke with and records we saw. People, relatives and staff were positive about the service and how it was led. One person said, “It is excellent all carers are professional friendly and they come on time.” A relative said, “They really listen, they took on board everything and there is consistency of staff.”

Staff were aware of their roles and responsibilities and had opportunities to raise any issues or concerns. Staff told us they loved their jobs and working for the provider. The felt confident they would be listened to. Staff comments included, “We give a wonderful service, I have never had any complaints” and “It is lovely I am glad to be part of the team” and “I think they have been excellent.”

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve.

The service had a quality assurance system in place. Audits and checks were undertaken regularly. This meant the quality of the service was able to continually improve.

We visited Audley Care Limited and during the visit we spoke with one person who used the service, two staff and two managers. We later spoke to 12 people who use the service and seven of their relatives over the telephone. The former manager of the service is no longer employed by Audley Care and the new manager had been in post for two weeks at the time of our visit.

We found that care and support was planned and delivered in a way that was intended to ensure people’s safety and welfare. “They ring the bell and call out. They have happy smiling faces.” “They are very pleasant. I am happy with the service.” “They never rush and they stay for the right time. I don’t have to worry. It’s a fantastic agency. The carers are wonderful and highly-trained.”

Staff at Audley Care were suitably qualified, skilled and experienced. There were enough staff to meet people’s needs.

The provider had some systems in place to assess and monitor the quality of service that people received, however we found that these systems were not being effectively implemented.

We spoke with two people who used the service. They told us "I can't speak highly enough of the service" and "they're fairly prompt". We spoke with the relative of a person using the service who told us "we have regular carers, they come at the time that we prefer and they always ring me if there are any changes".

We spoke with staff four staff members. One told us "the care that people receive is personal and excellent" and another told us "the care is really good, the company have very high standards".

We found that people were involved in the planning of their care and that they were provided with opportunities to feedback about the service. We saw that people's needs had been assessed and a care plan produced. We found that staff received appropriate training and that they felt supported. We saw that the service carried out quality assurance checks and audits. We had concerns that people's care plans were not being regularly updated and were not always clear which meant that there was a risk that people's needs were not being met.