Bridgnorth Homecare Co Operative Limited is a domiciliary care agency registered to provide personal care to people of all ages living in their own homes.

The inspection of this service took place on 21 July 2016 and was announced.

There was a registered manager in post who was present at the time of the office visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, registered managers are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People received safe and effective support from the agency. Staff knew how to recognise and report any risks, hazards, problems or potential signs of abuse. Systems were in place to assess and manage risks. Staff only had minimal involvement in administering medicines but processes were in place to promote safe practice when required.

People were supported by staff who had sufficient time to carry out tasks required of them and people enjoyed flexible and responsive support. The provider’s recruitment procedure ensured that people were safe to work for the agency.

Staff had the skills and knowledge to understand and support people’s individual needs. They received training and support when they started working for the agency. Their skills were kept up to date through regular training which was reviewed and expanded. Staff felt well supported by the registered manager and their colleagues.

Staff understood their roles and responsibilities and worked well as a team to ensure people’s needs were met effectively. They listened to people and responded effectively to suggestions for change.

People’s rights were protected under the Mental Capacity Act 2005. Staff promoted choice and encouraged involvement and decision making. People told staff how they wanted to be supported and staff responded positively.

People were supported to prepare food and drink as identified in their plans of care. Staff liaised with healthcare professionals when required to ensure people received support to maintain their physical and mental health needs.

People were supported by staff who were kind and caring. They were listened to and had trust and confidence in the staff who supported them. People received consistent support that enabled them to develop positive working relationships based on mutual respect. Staff were aware of people’s individual preferences and respected their privacy and dignity. Staff promoted people’s independence and care was individualised.

People, and their relatives, worked closely with the registered manager and the staff team to ensure they received a responsive service. Outside agencies recognised this and this led to positive working relationships that ensured people received the best possible service. People were asked if they were happy with the service provided. There were systems in place to ensure that people’s views and opinions were heard and their wishes acted upon.

There was a complaints procedure in place although no one had had cause to use it. People valued the informal approach to sharing worries or concerns.

The registered manager provided good leadership and there were systems in place to monitor and review the quality of the service provided. The registered manager was aware that they needed to develop and improve their record keeping to ensure that important information was written down should it need to be formally referenced.

People shared their experience of the care and support they received. Comments included, "The staff are supportive and caring and, “They have enabled me to stay at home”.

People considered that the staff met their current needs and were reliable. They said, "I am told who is coming and they never let me down". People considered staff were well trained to do their job and were sensitive to their wishes and preferences. People said the service was responsive to their changing needs.

The recruitment, induction and training of staff was managed and co-ordinated well. The registered manager ensured that new staff were properly supported to provide care to vulnerable people. Staff were enabled to acquire further skills and qualifications relevant to the role they were in.

People told us they were regularly asked if they were happy with their service. People knew how to complain and considered the office staff were accessible in times of need. Records kept at the office were very well maintained. The registered manager used these and people’s opinions to monitor the quality of service provision and make changes to improve the service where necessary. This meant that the service was effective and well led.

The purpose of this visit was to check that the provider had taken the actions required by us to meet essential standards of quality and safety.

We spoke with people who received a service and they told us that they remained satisfied with the service that they received. We also spoke with relatives who commented positively on the support provided by the agency.

We found that since our last inspection the provider had made improvements. We saw how care plans were more detailed. People told us that they had been consulted and involved in reviewing them. Staff told us that they had also been involved. Risk assessments were in place although they were in need of further development. The manager acknowledged that this was, “Work in progress”.

People told us that staff always respected their privacy and dignity and care records were now written in a respectful manner.

People who received a service were supported by a well trained staff team. Staff told us that they felt well supported by the management team.

People were protected because staff were confident to recognise and report abuse. Staff had received training in safeguarding vulnerable adults. Systems were in place to protect people’s money when required.

People who received a service were now consulted and involved in the delivery of the service. Their views and experiences were listened to. They also had systems in place to assess and monitor the quality of the service provided.

We carried out this review to check on the care and welfare of people using this service and to monitor the continual improvements made by the agency since our last visit.

At our inspection visit we were informed that Bridgnorth Home Care Cooperative actively provided a personal care and support service for approximately 40 people with a variety of needs.

We had telephone discussions with four people who used the service, two relatives

and five staff to ask their views on the quality of the service that the agency provided. We spoke with office management staff on the day of our visit to the office. We also had contact with a local authority professional who is involved in monitoring the service the agency provides.

We reviewed care and staff files and looked at management systems in place for monitoring the service the agency provides.

Everyone we spoke with told us that they were satisfied with the care and support that they received. One person commented “I am more than satisfied with the care and support from the agency. Some of the staff are superb”. Another told us “nothing is too much trouble”.

People told us that they felt involved and consulted in relation to how they received their support. People said that staff knew how to meet their needs. One person told us that the consistency in care provided by the agency was one of the strengths of the service provided.

Although people were happy with the care they received, we saw care plans lacked all of the details necessary for staff to follow to make sure they were doing all they could to keep people safe and well. We saw some details written about people had not considered their dignity. Some information was out of date and risk assessments to keep people safe did not match the actual needs of people.

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Although people said they felt safe and staff said they were confident to recognise and report abuse our findings were that management systems to protect people could be improved. We noted some staff had not received refresher training as often as they should to make sure they knew how protect people. We saw systems to manage people’s money were not robust.

People told us that they thought staff had the right training so they knew what they needed to do to care for them properly. These comments reflected what their care workers also told us. However we saw staff would benefit from opportunities to be supported and enabled to discuss their development, especially after they had been involved in incidents which had affected people’s wellbeing.

Everyone said that they would contact the office if they had any worries or concerns. People said that the office staff were easy to talk to, listened to them and they usually acted upon comments they made to improve their service.

The agency had systems in place to monitor the quality of the service provided and we saw evidence the agency had responded when issues for improvement had been identified.