The inspection took place on 25 and 26 June and was announced.

Bramley Homecare Ltd provides domiciliary support services and 24 hour care to people in their own homes. The agency provides care and support to older people and people diagnosed with dementia. At the time of our inspection there were 63 people receiving personal care from the service. There was a central office based just outside Shaftesbury.

Not everyone using Bramley Homecare Ltd received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had a registered manager in place. 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 did not consistently receive safe care because staff were not all aware about the risks people faced or how to manage these. Staff had good relationships with people, but care plans did not identify people’s risks or provide staff with clear guidance about how to manage these.

People’s capacity to consent to decisions about their care and treatment had not been assessed, or decisions made in peoples best interests in line with the Mental Capacity Act 2005.

Quality Assurance measures were in place but consideration was needed to ensure that the frequency and content of these provided sufficient oversight of the service people received and could effectively identify issues and drive improvements.

Care Plans were not person centred and lacked detail about people’s histories, what was important to them and how their conditions and risks affected them. Staff who completed initial assessments, care plans and reviews had not received training in areas relevant for this role and this was being arranged following the inspection.

People were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns.

People were supported by enough staff to provide effective, person centred support. Staff were recruited safely with appropriate pre-employment checks and received training and support to ensure that they had the necessary skills and knowledge to meet people’s needs.

People received their medicines as prescribed and staff worked with healthcare professionals to ensure that people received joined up, consistent care.

People were supported from the spread of infection by staff who understood their role in infection control and used appropriate Personal Protective Equipment (PPE).

People were supported to have enough to eat and drink. People’s preferences for meals were well known and staff offered people choices about what they ate and drank.

People received personalised end of life care from staff who understood their wishes and preferences and ensured that these were respected.

People and those important to them were involved in planning the support they would receive and were asked for their views about the support and any changes to people’s needs. Reviews identified where people’s needs had changed and reflected changes to the support provided in response to this.

People were supported by staff who respected their individuality and protected their privacy. Staff had undertaken training in equality and diversity and understood how to use this learning in practice.

Interactions with people were kind and caring and we observed that people chatted with staff and were comfortable with them in their homes.

People were supported to access healthcare professionals when required and the service worked with external agencies where needed.

Staff were confident in their roles and fel

This inspection took place on 17, 22 and 23 March 2016. It was carried out by two inspectors.

Bramley Home Care is registered to provide personal care to people living in their own homes. At the time of our inspection the service provided personal care and support for 60 people. The core hours of the service were 7 am to 10 pm. There was a 24 hour on-call service available.

The service is required to have 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. The current manager was in the process of applying to be registered and was waiting for checks to be completed.

People told us staff were caring and respectful. People gave us examples of staff treating them with kindness and going the extra mile for them. Such as one member of staff always dropped the local newspaper off to one person because they knew they liked it. Another member of staff brought fish and chips to someone else. A relative told us their relation looked forward to the social interaction with staff and it was as important as the personal care they received. People told us staff treated them as individuals and got to know them well.

People were involved in planning their care and plans were developed based on individual needs and preferences. There was a system for ensuring that reviews took place and people were visited at home by a senior member of staff to ensure that people were receiving the care they needed. Care plans were updated as necessary following a review. People told us their care records accurately reflected the care they received.

There were enough staff to ensure that people received their visits as scheduled and people usually had the same staff group supporting them. People told us that staff usually arrived on time and would contact them if they were going to be late due to traffic or an emergency. Staff told us they had enough travel time between visits and felt they had time to support people safely and in accordance with the persons care plan.

Staff described being proud of their work and spoke warmly about people they supported. They felt they were able to do a good job because people had choice about the care and support they received and were involved in developing their care plan.

Staff received appropriate training which prepared them to carry out their jobs. New staff completed an induction period which was adapted to each individual member of staff based on their experience and confidence. Staff received regular supervision and appraisals were booked.

The manager was motivated and keen to continually find ways of improving the service. People were confident with the manager and told us they were approachable. One person told us they could phone or pop into the office at any time. The manager had systems in place to monitor the quality of the care that people received. Spot checks were carried out on staff and records were reviewed. People were able to provide feedback on the service through quality surveys.