We inspected this service on 8, 9 and 10 November 2016. This was an announced inspection and we telephoned two days’ prior to our inspection in order to arrange home visits and telephone interviews with people. The service provides care and domiciliary support for older people and people with a learning disability who live in their own home in and around Swadlincote.

Our last inspection took place in October 2015 and at that time we found the provider was meeting the regulations we looked at and the service was given an overall rating of Good. Improvements were required within our question of Well-led as a registered manager was not in post and investigations of incidents did not always clearly demonstrate how the provider could make improvements within the service.

The provider of the service is now the 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.

We found improvements had been made with how incidents had been investigated. Where incidents had been reviewed, the provider had taken necessary action to make changes to the service to ensure improvements were made. Quality assurance systems had been developed to monitor how the service was delivered and people were able to comment on the quality of the service. Where people raised concerns these were addressed and changes made to people’s satisfaction.

Where people lacked capacity, this had not been assessed and it was not clear how some decisions had been made and whether people could make the decision for themselves. We recommended that further training was researched and where concerns about capacity was identified, capacity assessments needed to be completed to ensure decisions were made in people’s best interests.

Staff sought people’s consent before they provided care and support and people were involved in the planning and reviewing of their care. People were treated with dignity and respect by staff who understood the importance of this. People had support to take their medicines at the right time and staff knew how to act if medicines were missed. Where assistance was required, people received support to prepare and eat their meals and had access to food and drink between support visits.

Staff knew how to recognise the signs of abuse and knew what actions to take if they felt people were at risk of harm. Where risks had been identified, measures were taken to reduce or prevent potential risks to people. People were able to raise concerns if they were not happy with the service provided and action was taken by the provider.

There were enough staff to meet people’s identified needs and people received support from staff who knew them well and who had received training to be able to meet their specific needs. People benefitted from receiving a service from staff who worked in an open and friendly culture and were happy in their work and supported by senior staff. Staff received supervision from senior staff who reviewed their work to ensure they were competent in their role.

We inspected this service on 7 October 2015 and the inspection was announced. This meant the provider and staff knew we would be visiting the service before we arrived. Our last inspection was carried out on 17 May 2013 when the service was found to be meeting the Regulations we looked at.

Bradcare provides personal care and support to people living in their own homes in Swadlincote and the surrounding areas. At the time of our inspection, 80 people were receiving a service.

There was no 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. At our inspection, the provider told us they were acting as the manager.

The provider investigated accidents, incidents and complaints. However, they did not always follow their procedures and improvements were needed to address all concerns to ensure lessons were learnt.

Staff understood how to protect people from abuse and avoidable harm and were responsive to their needs. People were protected against the risk of abuse, as checks were made to confirm staff were of good character to work with people in their own homes. Sufficient staff were available to meet people's needs.

People’s needs were assessed and care plans were in place to guide staff on how to meet people’s needs effectively. Staff were provided with training and support to meet people’s specific needs. The staff understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) which is legislation that protects people who cannot make decisions for themselves. People’s needs and preferences were met when they were supported with their dietary needs. People were referred to health care professionals if their needs changed.

Staff treated people in a caring way, respected their privacy and promoted their independence. Staff spent time getting to know people and chatted to them during visits to promote their wellbeing. People were supported to follow their hobbies and interests.

People were encouraged to give their feedback on the service and most people were satisfied that their concerns were acted on.

We spoke with five people using the services and three care workers who were new to the agency.

One person told us “staff will always ask me what I want or prefer and they do everything that I want”.

Another person told us “staff will listen to you I find them 100% respectful”.

People we spoke with told us staff were; well trained, knew what they were doing and were respectful towards them. One person told us “staff will always encourage me to do what I can for myself this is good for me”.

Three people told us if they needed help to contact a doctor or nurse at their surgery their care worker would help them to do this. They all said they found the staff to be supportive and helpful to them. This shows staff were willing to work with other agencies.

Three people confirmed they received a copy of their staff rota delivered at the beginning of the week by care workers.

People we spoke with told us they received care provided by their own regular care workers and this meant a lot to them.

One person told us if a care worker was late this was understood to be due to the recent road improvements in the area. Everyone who spoke with us told us they had never had a missed visit. They were completely satisfied by the service provided. Two comments on the quality of the service included “when I was recently upset by an incident all the care workers were supportive. It is a nice agency”.

“The service is fantastic I cannot fault them. Nothing is too much trouble”.