This inspection was announced and took place on 26 & 27 October 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office. It also allowed us to arrange to visit people receiving a service in their own homes.

Candlelight Homecare is registered for the regulated activity ‘personal care’. At the time of the inspection Candlelight Homecare Glastonbury Area Office was providing care to 174 people in their own homes.

The last inspection of the service was carried out in January 2014. No concerns were identified at the time of that inspection.

There is a 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.

There was a stable management team who took appropriate action to make sure they provided a safe and reliable service for people. They monitored the quality of the service and aimed to continually improve. One person said “They organise it all well. It seems very efficient.”

People told us they found the service to be reliable and mostly staff arrived at the specified time. One person told us “They’re usually on time and if I need an earlier appointment they accommodate me. They always let me know if they are going to be late.”

Staff were well supported and received the training they required to carry out their jobs. People who used the service felt safe with the staff who supported them. People told us staff were well trained to help them. Comments from people included; “They are definitely good at what they do” and “They absolutely know what they are doing.”

The agency’s robust recruitment procedure and staff training helped to minimise the risks of abuse to people. All staff carried identification cards and there were systems in place to make sure people’s personal information was protected.

People received care and support from staff they knew well and had built trusting relationships with them. People were extremely complimentary about the staff who visited them. One person said “They do so much more than is in the care plan. I can honestly say Candlelight has made my life so much better.” Another person told us “They will do anything for you. They are more than people just doing a job.”

There were systems in place to make sure people’s needs were assessed and they were able to be involved in all decisions about their care packages. People were supported to access healthcare professionals and the service was flexible which enabled people’s changing needs to be met.

People said they continued to remain in charge of the care they received and staff always consulted them about how they wished to be supported. People told us the service helped them to remain independent. One person said “I am so lucky to still be in my own home. It’s because of the care I get that I can stay here.”

People were treated with respect and dignity and were able to make choices about the staff who supported them with personal care. When new staff began work for the agency they had to sign a ‘Dignity statement’ to say that they would always treat people in a way that respected their dignity. One member of staff said “We treat everyone as we would want our loved ones to be treated.”

People knew how to make a complaint and were confident any issues raised would be investigated and resolved. The agency used feedback from people to monitor the quality of the service and identify how improvements could be made.

During this inspection of the agency we contacted 16 people by telephone. We sent out 60 postal questionnaires to people to obtain their views and received 24 responses. We visited four people in their own homes. We made visits to the agency's office and spoke with four staff members. We also observed one member of staff in the community.

All sources of information indicated people using the service and their relatives and/or friends were satisfied with the service being provided by Candlelight Homecare. When any areas of concern were identified either through the inspection or through the provider's internal monitoring processes prompt action was taken to address and resolve the concern. Some people were very pleased with the care they or their relatives received.

People told us they were treated with respect and their dignity was maintained. We heard “I am always treated with dignity and respect. I get the same two girls every day. We have good rapport; if they are going to be late they call me and let me know.”

We visited four people receiving a service from Candlelight Homecare with a member of staff. We saw the agency effectively supported people to be independent and remain at home. This was confirmed by the responses to the questionnaires sent by the Care Quality Commission. We were told “I am on my own most of the day. I have three visits and they (the care staff) are the highlight of my day. I have a regular team. They help me in any way I need.” We were told how the support staff’s regular attendance enabled other family members to go to work knowing they could rely on the Candlelight Homecare service.

We were told by people who used the service the staff were very caring. We were told by a relative staff were “like two extra daughters” and “they do as much as they can for me.” This person also told us the company found time to come and help with their relative who needed assistance between visits. “Sometimes” they told us “they were there in ten minutes.”

We heard people found the service was responsive to their needs. One person who had been unwell told us "They have been coming to me for several years in the morning. They are very helpful. At the moment they are coming three times a day until I feel better.” People told us they received the support they wanted and, if not, they were able to discuss this with the staff or the care managers.

We saw the provider had a policy and procedure for the safe administration of medicines and other clinical tasks provided by the service. Prompt action was taken by the provider during the inspection to improve the record keeping relating to one person’s medication and food records.

We found the agency operated a system of recruitment which was designed to employ staff who were suitable for their post and safe to care for people at home. People who spoke to us or returned our questionnaires made a number of positive comments about the carers and their kindness.

The agency had systems in place to monitor the service they were providing and was demonstrated a commitment to maintaining and improving the care and support for people.

We visited three people who receive services from the agency and telephoned seven others. We also spoke with a relative of someone receiving services from the agency. People told us they were very happy with the care and support they receive from the agency. They said the carers always treat them respectfully. Some said the carers are “very kind”, “wonderful”, “can’t fault them”, “I would recommend the agency to anyone”. Others said, “excellent care” and “all of them are so lovely”.

Some people said that staff members always wore appropriate and protective clothing when providing care. We observed this during visits to people receiving services.

People told us they usually have the same staff care for them each visit. One person told us “it didn’t matter who came, all the girls are lovely”. Some people required two members of staff for each visit because they had to use a hoist. They said they feel safe and comfortable when being hoisted. We read a care plan for a person who uses a hoist. There was clear information provided to staff, including risk assessments and manual handling techniques.

People said that staff members were usually on time. Some people said that occasionally staff got held up in traffic. People told us that if they are ever concerned about a staff member or if staff were late they would ring the agency. Some people told us they felt safe with the care they received. They said they felt that staff members were trustworthy and well trained.

Some people who receive services from the agency have some of their meals cooked by agency staff. People said the staff members were very good in making sure they had everything they need. They said the staff would make sure their meals were on time, would make them drinks and leave their kitchen tidy.

People told us they have a “folder” that tells the staff what their needs are and what they have to do to meet them. We read some of these during visits to people receiving services. The folder contained detailed assessments of need and risks with clear guidance on how to meet those needs safely. There are records for staff to record the care given each time. The agency carries out regular spot checks on all aspects of care delivered, including the paperwork. People said the agency involves them in all aspects of their care and support. They said one of the managers will sit down with them and discuss all their needs and discuss their care and support. We were told that the agency always asks them if they are happy with the care they receive during reviews and when they are asked to complete satisfaction questionnaires. People felt they were listened to and their views are acted on.

Some people using the agency services told us that staff members support them with their medication. They said staff members are very careful when giving them their medication. They said staff members explain what they are giving them and sign to say it has been given. Some people said they felt the staff members are “very well trained”.

Some people told us they receive services from more than one agency. They said it worked well and the agencies communicated well with each other. People told us that the agency works closely with district nurses and their GPs when necessary.

People told us that the agency completes an assessment of their home to ensure it is safe. We read some people’s records and found assessments of risk on the environment were detailed and reviewed regularly.

People told us they are provided with information about the agency, this includes contact details of the agency, how to raise concerns and complaints and information about the cost of the service. We saw copies of this information in people’s records during visits to people using the service. People also told us they complete satisfaction surveys on a regular basis.

People who use the agency said they receive information from the agency that tells them that all staff members go through a robust recruitment process. Some people said this made them feel safe.

During our inspection we spoke with nine people who used the service and six members of the care team. We read five care plans to see how people’s care was assessed, planned and delivered. Out of the nine people we spoke with we visited five people in their own homes and spoke with four people on the telephone. This enabled us to gain people’s experience of what it was like to receive their care and support from the service.

People spoken with were very pleased with the care and support they received. People commented; “they are a wonderful organisation, I don’t know what we would do without them”, another person said “overall it’s a good service, I can still be independent, they are like a lifeline”. Another person said “there is nothing Candlelight can do better”.

People were involved in their care and treatment because they had regular reviews routinely and when their needs changed. Staff were trained appropriately so they could meet people’s needs. The service encouraged further development and training to increase staff’s knowledge and expertise.

The service carried out regular spot checks and observations on its staff to ensure they were providing a good service. Poor practice was identified and managed through supervisions and further training.