Balm Care is a domiciliary care agency that provides personal care to people living in their own houses and flats in the community. Balm Care provides a service to people living with dementia, learning disabilities or autistic spectrum disorder, mental health, older people, sensory impairment and physical disabilities. At the time of our inspection visit they provided a service to 23 people and employed 17 care staff.

At the last inspection in April 2015, the service was rated Good. At this inspection we found the overall rating remains Good.

Since our last inspection we have reviewed and refined our assessment framework, which was published in October 2017. For this inspection, we have inspected all key questions under the new framework, and also reviewed the previous key questions to make sure all areas were inspected to validate the ratings.

The office visit took place on 14 February 2018 and was announced. We told the provider we were coming so they could arrange to be there and so they could contact people, to seek their permission for us to speak with them about their experience of using this service.

The service had 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.

There were procedures to keep people safe and manage identified risks to peoples care. People felt safe using the service and staff understood how to protect people from abuse and harm.

People who required support to take medicines received these mostly from family members. However where staff administered medicines, staff were trained and assessed as competent to do so. The provider’s recruitment process was thorough and ensured pre-employment checks were made, prior to staff starting work, to ensure they were suitable to support people who used the service.

Staff used protective clothing, such as disposable gloves and aprons when providing personal care, to reduce the risk of infection being passed from one person to another.

People had an assessment of care completed before they used the service to make sure staff could meet people’s care and support needs. People said care staff usually arrived around the time expected and stayed long enough to provide the care outlined in their care plan. Care plans provided information for staff about people’s care needs and the details of what they needed to do on each call.

The registered manager and staff followed the principles of the Mental Capacity Act (MCA). Staff respected decisions people made about their care and gained people’s consent before they provided any care or support.

People told us they received care from staff who knew them well and from staff who were kind, caring and considerate to their needs. People said staff treated them with dignity and respect and relatives were confident their relations were looked after well. Staff knew the people they visited very well and spoke about people in a caring and considerate manner.

People’s care needs were regularly reviewed. The registered manager and office staff were in regular contact with people, or their relatives, to check the care provided was what people needed and expected. People knew how to complain and information about making a complaint was available for people when they started using the service. People knew who the managers were and felt they listened to them and dealt with any concerns they had.

Staff felt supported to do their work effectively and said the managers and provider were approachable and available. There was an ‘out of hours’ on call system, which ensured support and advice was always available for staff.

The provider's quality monitoring systems included asking people for their views about the q

The inspection took place on 17 and 21 April 2015 and was announced. We told the registered manager two days before our visit that we would be visiting to ensure the registered manager was available.

Balm care is a domiciliary care service that provides care and support to people living in their own homes. Some people’s care was funded through the local authority and some people purchased their own care. At the time of our inspection nine people received support from this service.

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.

All staff spoken with knew how to keep people safe from abuse and harm because they knew the signs to look out for. Where incidents had occurred the provider took action to help in reducing re occurrences.

People were protected from unnecessary harm because risk assessments had been completed and staff knew how to minimise the risk when supporting people with their care.

There was enough staff that were safely recruited and trained to meet people’s needs.

People were supported with their medication and staff had been trained so people received their medication as prescribed.

People were able to make decisions about their care and were actively involved in how their care was planned and delivered.

People knew who they could raise their concerns with and felt confident they would be listened to. No complaints had been made about the service provided.

Staff supported people with their nutrition and health care needs and referrals were made in

consultation with people who used the service if there were concerns about their health.

Processes were in place to monitor the quality of the service provided. People who used the service were asked to comment on the quality of service they received. The information provided from people was used to improve the service where possible.