Care at Home UK Limited provides live-in support and personal care to people in their own homes. Care workers are allocated to live-in with people for up to twelve weeks at a time. The agency provides care in several counties including, Essex, Suffolk, and Oxfordshire. At the time of our inspection, support was provided to 22 people.

When we last inspected Care at Home Uk Limited in June 2015 we rated this service good. At this inspection we found that the service remained good.

There was 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.

Staff understood the need to protect people from harm and the steps they should take if they suspected abuse. The agency was aware of their responsibilities to keep people safe and we saw that they, and care staff took steps to protect people and reduce the likelihood of harm. Medicines were safely managed and subject to regular checks to ensure that they were being administered as prescribed.

There were sufficient numbers of staff available to cover for absences and meet peoples needs. Recruitment procedures were thorough and reduced the likelihood of the service employing individuals who were unsuitable to work in this type of service.

Staff were well motivated and supported. They received training to meet the needs of the individuals they supported. Staff had a good understanding of healthy eating and the feedback from people using the service was that they enjoyed the meals provided. We saw that staff sought advice appropriately from health professionals and followed their recommendations.

People were supported to have control of their lives and staff supported them in the least restrictive way.

People told us that staff were kind and caring and they were enabled to retain as much independence as possible. Support was underpinned by detailed care plans which set out people’s needs and how they wished the support to be provided. Communication was effective and key information was handed over to other staff and relatives ensuring that people received consistency of care. There was a system in place to address peoples concerns.

The manager was accessible and there were clear arrangements in place to support people who used the service and staff outside of office hours. People and staff told us that the manager provided effective leadership and the service worked well. Regular audits and checks were undertaken to identify any shortfalls and to drive improvement.

Care was planned and delivered in a way that ensured people’s safety and welfare. We spoke with four people who receive a service from the agency and the relatives of two other people. Without exception people made very positive comments about the care they received. People told us that they were, “Very happy” with the service, and a relative told us the service had “…been exemplary.”

People told us that the care they received from this service met their needs. One person told us that care workers always consulted them about the care they provided and were “…solicitous of my well-being”. A relative told us, “They are my life line. The carer knows [my relative] so well.” They described the service their relative received from the agency as “incomparable.”

We found that people were not protected against the risks associated with medicines. This was because the provider did not have appropriate arrangements in place to manage medicines that were administered from monitored dosage systems.

During our inspection on we found there were effective recruitment and selection practices in place. This meant people were cared for by suitably qualified, skilled and experienced staff.

We found there was an effective complaints procedure in place.

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others and to assess and monitor the quality of service that people receive.

The inspection took place between 04 and 11 June 2015 and was announced.

Care at Home UK Limited provides live-in personal care to people in their own homes. Care workers are allocated to live-in with people for up to twelve weeks at a time. The agency provides care in several counties including, Essex, Suffolk, and Oxfordshire. At the time of our inspection, care was provided to 21 people.

A registered manager was not in place but an individual had been appointed and told us that they were in the process of applying for registration. 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 the last inspection in September 2013, we identified a breach of the legal requirements and we asked the provider to make improvements as medicines were not being managed safely.

At this inspection we saw that improvements had been made to medicines management and the arrangements were safer.

People using the service were protected from the risk of abuse because the provider had provided guidance and training to staff to minimise the risks of abuse. People felt safe and had good relationships with their carers.

Risks to the environment and to individuals were identified and there were clear plans in place to manage them. Accidents and incidents were monitored and reviewed and steps taken to reduce the likelihood of a similar issue occurring.

Staffing was organised to ensure that people received care from a consistent team of staff and clear handover arrangements ensured that carers knew peoples individual needs and preferences. There were arrangements in place to respond to unforeseen events and emergencies.

Staff were trained and their practice supervised by the agency. The manager had a good understanding of the Mental Capacity Act (2005) and we saw that people were consulted about their care and support needs. People were supported to maintain a balanced diet and had good access to health care support.

Staff were caring and supported people to maintain their independence and their interests. Care plans were person centred and regularly reviewed. When people’s needs changed the agency were proactive in seeking advice.

People were aware of the complaints procedure and expressed confidence that issues would be investigated and addressed.

The manager was visible and accessible and aware of the needs of the people using the service. Staff were well supported by the manager and office staff. Audits and spot checks identified areas for improvement and where gaps were identified they were actioned.