This was an announced inspection that took place on 2 November 2016.

Merseyside Domiciliary Care service is part of the Brothers of Charity organisation and provides personal care and support to people living in their own homes. At the time of this inspection the service was supporting nine people living in two properties within the grounds of Thingwall Hall.

A registered manager was 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.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People are protected from abuse as the registered provider had developed robust procedures in relation to safeguarding people. Staff had received training in safeguarding people are knew who they needed to contact to report any concerns they had.

Systems were in place to identify, assess and plan for known risks to people. Clear guidance was available to staff as to how they assessed risk with people. Regular monitoring took place of risk associated information to ensure that it was up to date and remained effective.

Safe staff recruitment procedures were in place. The process involved obtaining references and carrying out checks to help ensure that only staff suitable to work with vulnerable people were employed.

Robust training was available to staff. This helped ensure that people were supported by staff who knew current best practice in delivering care and support safely.

People healthcare needs were assessed and planned for. This meant that people received the appropriate medical support when they needed it.

People were involved in shopping for food and planning their meals with the support of staff who knew and understood their likes, dislikes and personal preferences.

The registered manager and staff had a detailed knowledge of people’s rights to decision making under the Mental Capacity Act 2005.

People had access to a robust complaints procedure. People knew who to speak to if they were not happy.

People’s differing communication needs had been considered by the service. Documents relating to people’s care and support, along with meeting minutes and procedures had been published in large print with the use of symbols and pictures.

People had detailed care and support plans in place that were available to staff. This helped ensure that staff were aware of how people wanted to be supported.

Procedures were in place for the safe management of people’s medicines. This helped to ensure that people received the support they required with their medicines.

Positive relationships had been formed between people and staff. It was evident that they knew each other well. This helped ensure that people received the care and support how they wished.

People were asked for their opinions of the service during regular meeting and by completing survey forms. This demonstrated that people’s views were considered when planning changes to the service.

Robust systems were in place to regularly check on the quality of the service delivered to people and that when required, improvements were made. These checks included daily, weekly and monthly audits.

People confirmed that they were treated with respect and their dignity was maintained. They also told us that they were satisfied with the standard of care provided and were of the opinion that staff understood their needs.

We were able to speak individually with two of the people using the service who told us they were happy with the support provided by Thingwall. Some comments made were "If I have a problem I know who to tell”; “I can get what I need” and “I like the staff”.

We found they were treated respectfully, given support to have their say in how they wanted to be helped and were supported to do the things they wanted to do.

Systems were in place to offer protection to the people who use the service from abuse and people spoken with confirmed that they felt safe and had no concerns regarding the care provided.

The people who accessed the service provided by Thingwall were cared for by staff that were appropriately recruited, well trained and experienced at supporting them.

No complaints, concerns or allegations were received from the people using the

service during our visit and the provider confirmed that they had not received any formal complaints in the past 12 months.

We used a number of different methods to help us understand the experiences of people supported by Thingwall. This was because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We were able to speak individually with two of the people using the service who told us they were happy with the support provided by Thingwall. Some comments made were “It’s lovely” and “I do very well”. We also looked at some feedback on the service by relatives, who commented:

“We’re very satisfied with all the care”.

“We are all happy with the current situation”.

“We cannot overestimate the attention given to my brother”.

We found people were treated respectfully, given support to have their say in how they wanted to be helped and were supported to do the things they wanted to do. The people who accessed the service provided by Thingwall were cared for by staff that were appropriately recruited, well trained and experienced at supporting them. The organisation monitored the quality of the service provided on a regular basis.

We spoke to people’s advocates and relatives, who told us,

"I am very happy with the care given",

"The girls are second to none, kind and so understanding. They are absolutely essential to both mine and [name of person] life could not and would not want to be without them".

"Always happy and smiling",

"What would life be without them unthinkable I am blessed that they are so good",

"Could not be in better hands" and "I am sure that they keep [name of person] safe. I am confident that the care they give is just as he needs".

Social services told us that there have been safeguarding concerns and these have been appropriately reported and addressed by the service.