About the service: Belong at Home Macclesfield is a domiciliary care agency which supports people in their own homes. At the time of our inspection 38 people were in receipt of the regulated activity ‘personal care’. They provided services to adults with a variety of health needs.

People’s experience of using this service:

People felt safe and spoke of being supported by a consistent staff team who knew them well and took the time to chat with them on visits and were on time and never rushed.

Staff had travel time built into their rotas in order that they could get between visits and still arrive at each call on time. Where they noticed changes in people’s health needs and people needed more time within visits, staff were able to raise this, and call times would be adjusted accordingly. Calls were monitored via a telephone system which activated the office staff if a member of staff had not turned up at a call and action could be taken to resolve this.

Risks were managed safely, and staff had clear instructions on how to keep people safe. They were aware of safeguarding policies and what steps to take if they suspected someone may be at risk of harm.

Medicines were managed safely, although we noted there was some written guidance on medication that is given when necessary in care plans, this could be clearer. The registered manager agreed to improve this guidance immediately.

Staff were recruited safely and given enough support to develop their knowledge and skills to do their job. They underwent a tailored induction into the company and ongoing training to do their job. They spoke with pride of working for Belong and felt that the provider invested in their development and supported them in their roles.

People and their relatives spoke of staff who were kind, patient and caring. They commented that staff knew them well, always asked permission before carrying out any tasks and often asked if there was anything else that they could do. Family members spoke of staff communicating well with them about any changes to their loved one’s health or wellbeing, so they felt secure in the knowledge their loved one was receiving good care.

Care plans and documentation was clear, detailed and was regularly reviewed. People and their relatives felt involved in the care as regular reviews were held to discuss their care.

The service was responsive to people’s needs and flexible. People and their relatives could request additional calls, and these were accommodated by the service.

People were clear on how to make a complaint and were confident that their concerns would be acted upon.

People, relatives and staff were positive about the registered manager and felt that the service was well run. They considered that the service displayed the provider’s values of ‘putting customers at the heart of all we do’.

The provider had robust quality assurance systems that were effective at identifying areas for improvement and these were acted upon in a timely manner. Regular staff meetings were held so staff were kept up to date with any changes and good practice. The service worked well with other professionals and acted upon advice to support people’s health and wellbeing.

Rating at last inspection: Good (Report published 27 October 2016)

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

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

The inspection was unannounced and took place on 11 and 12 August 2016. This service was last inspected on 26 February 2013 where it was found to be compliant in all the areas we looked at.

Belong at home is a domiciliary care agency providing personal care and support to people who live in the Macclesfield and surrounding areas. The service is based within Belong Macclesfield care village and is managed by CLS Care Services Limited, a not for profit organisation based in the North West of England. The village is situated on the outskirts of Macclesfield in a residential area. Local community amenities such as shops, a pub and a bus stop are within a short walking distance. At the time of our visit the service was providing care and support for 45 people. Timing and frequency of visits were dependent on people’s varying needs.

The service has a registered manager. 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. At the time of our visit the registered manager was in the process of handing over her role to the current manager of the service. We saw that the manager had completed her application to become registered with the Care Quality Commission.

We found that people were provided with care that was safe, person centred, sensitive and compassionate. The service was managed and staffed by a consistent team of support workers who were well trained and well supported.

The safety of people using the service was taken seriously by the registered manager and staff who understood their responsibility to protect people’s health and well-being. The registered manager and staff had received training about protecting people form abuse and they knew exactly what action to take if they suspected abuse. Risks to peoples’ and staff safety both internally and externally to the person’s home had been addressed and recorded with measures put in place to manage any hazards identified.

Staff had received the training and guidance they needed to assist people in the right way including helping them to eat and drink enough. People had been assisted to receive all the healthcare assistance they needed. Staff had ensured that people’s rights were protected because the Mental Capacity Act 2005 Code of Practice was followed when decisions were made on their behalf.

We looked at staff recruitment files to check that effective recruitment procedures had been completed. We found that appropriate checks had been made to ensure that they were suitable to work with vulnerable adults.

We asked staff members about training and they all confirmed that they received regular training throughout the year and that this was up to date and provided them with knowledge and skills to do their jobs effectively.

People who used the service told us that the standard of care they received was good. Comments included, “I feel that I have an extended family as that’s what the staff are like to me”, “I really don’t know what I would do without them” and “They are all so good I could never imagine life without them”.

Relatives spoken with praised the staff team for the quality of care provided. Comments included “The staff know (name)’s needs and meet them very well” and “I am so pleased with the services provided to (name). Staff are reliable, kind and caring and know what they are doing”. Staff members we spoke with were positive about how the service was being managed and spoke about the staff team in general being very supportive and of feeling part of a family.

There was an internal quality assurance system in place to review systems and help to ensure compliance with the regulations and to promote the welfare of the people who used the service. This included audits on care

During our visit to the agency and as part of our review we spoke with six people who receive care from the agency and one of their relatives. All those we spoke to said they are treated well and with respect and all said they are involved in making decisions about the care they receive and the way their service is provided and delivered.

They all said that the service is reliable, prompt and well provided. For example, one said ‘the service is excellent and everything asked for is done and done well’. They were also very positive about the support workers who provide care using words such as ‘caring’, ‘pleasant’, ‘always smiling ’ and ‘easy to talk to’ to describe them. The people we saw living in the Belong apartments looked well and well cared for.

They said they are supported to be as independent as possible, are happy living there and there is a lot going on to keep them busy.

At the time of our inspection visit the co-ordinator who manages the service on a day to day basis was away from work and the service was being managed by a senior support worker.

We looked at a copy of the service user guide and found that this provided a clear, user friendly description of what people could expect from the service and outlined people's rights and responsibilities.

The people we spoke with told us that their support needs were being met and that they liked the staff members supporting them. Comments included; “carers are fantastic”, “very pleasant and easy to get on with”, “they are marvellous”, “pure excellence, I would recommend anybody to them” and “very happy with them”.

Belong at home had a safeguarding policy in place.

There were effective recruitment and selection processes in place and before staff members were able to support people with their personal care needs they had to complete an induction so they would have the skills they needed to do their jobs effectively and competently.

Information about how to complain or comment was clearly explained in the service user guide that was given to everyone when they start using the service.