Care Counts is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, including people living with dementia and disabled adults. At the time of this inspection, 120 people were being supported by the service, 84 of these were in receipt of the regulated activity, ‘personal care’.

People's experience of using this service:

¿ People told us they received a service that made a difference and improved their lives. One person told us, “They’re indispensable.” Relatives also shared very positive feedback.

¿ We found the service had deteriorated in some domains since our last inspection.

¿ The service met the characteristics of requires improvement in three out of the five key questions.

¿ We found one breach of the regulations in relation to consent. The provider was not completing decision specific mental capacity assessments and best interest decisions for people who lacked the capacity to make decisions about their care. Staff had received training in this area however their knowledge was limited.

¿ We have made two recommendations in relation to medicines, and checks on lifting equipment used by care workers.

¿ The provider had organised thematic activities as a way of offering opportunities for people, relatives and staff to socialise.

¿ People were supported by staff who were motivated, enjoyed their job and felt well supported through regular supervisions assessments of their competency and training.

¿ The management had a clear vision about the quality of care they wanted to provide and there was an open and person centred culture in the organisation.

¿ More information is in the full report.

Ratings at last inspection: At our last inspection the service was rated good overall. Our last report was published on 12 July 2016.

Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Enforcement: Information relating to the action the provider needs to take can be found at the end of this report.

Follow up: We will continue to monitor the service to ensure that people received safe, high quality care.

Further inspections will be planned for future dates. We will follow up on the breaches of regulations and recommendations we have made at our next inspection.

The Inspection took place on 26 May 2016.

Care Counts provides a range of personal support services to people living in their own homes across the Kirklees area. At the time of our inspection 110 people were receiving support.

The service had a registered a 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 Act2008 and associated Regulations about how the service is run.

People told us they felt safe with the staff that supported them.

Staff received training in how to safeguard people from abuse. Staff were supported by the provider who had policies and procedures in place to support staff to act on any concerns raised. Staff were familiar with these policies and procedures. Staff understood what action they should take in order to protect people from abuse.

Risks to people's safety were identified, minimised and risk reduction measures were tailored towards individual needs so people could be supported in the least restrictive way possible and build their independence.

People and their families had been involved in planning their care.

People were supported with their medicines by staff that were trained and assessed as competent to give medicines safely. People told us their medicines were given in a timely way and as prescribed. Checks were in place to ensure medicines were managed safely.

There were enough staff to meet people's needs effectively.

The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people who received services.

People told us staff asked for consent before supporting them in ways they were comfortable with. People were able to make their own decisions and staff respected their right to do so. Staff and the registered manager had a good understanding of the Mental Capacity Act.

People told us staff were respectful and treated people with dignity, and records confirmed how people's privacy and dignity was maintained.

People were supported to make choices about their day to day lives. For example, they were supported to maintain any activities and access the community.

People's care records were written in a way which helped staff to deliver personalised care and gave staff detailed information about people’s likes and dislikes.

People were involved in planning how their care and support was delivered.

People told us they felt able to raise any concerns with the registered manager. They felt these would be listened to and responded to effectively and in a timely way.

Staff told us the management team were approachable and responsive to their ideas and suggestions.

There were robust systems in place to monitor the quality of the support provided.

During our inspection we spoke with the manager and eight staff. We also spoke with five people using the service and six relatives of people using the service.

Relatives and people using the service were very positive, comments included:

“Staff are consistent, we are treated as we would like to be treated.”

“We get regular carers, it has enabled us to have a life.”

We looked at four computer records for people using the service. We saw evidence of signed consent being gained from people or their relatives. We found the care records provided sufficient information to enable staff to meet people's individual needs.

We looked at five sets of staff records and found that effective recruitment and selection processes were in place.

Documentation also showed an effective system for auditing the quality of service.

We saw the company had a complaints procedure which gave details of who to complain to and the timescales in which a complaint would be acknowledged and investigated.

We spoke on the telephone with six people (or their relative) who received a service from this agency, to gain their views about the service. They told us they were very happy with the quality of care they received and were treated with dignity and respect. Everyone we spoke with said they had been involved in making decisions about their care and felt able to express their views. People thought they received a service which was personalised and met their individual needs. Comments included, “I don’t know what I’d do without them,” and “It’s the best I’ve known.”