This inspection took place on 11 April 2017 and was announced. We gave 48 hours’ notice of our inspection to ensure that staff were available to provide the information we needed and we could make arrangements to speak with people who use the service.

Care Packages UK Limited provides personal care to people in their own homes. At the time of our inspection the service was supporting six people. We last inspected this service in January 2016 when the service was assessed overall as ‘Good’. Some improvements were needed to the system for monitoring the quality of the service and at this inspection we found these had been done.

At the time of the visit the service had a registered manager. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff received training in recognising and reporting any signs of abuse. The registered manager had assessed and recorded the risks associated with people’s medical conditions

People told us and records confirmed that people received their calls at their chosen times and by the number of staff required to keep them safe.

People received their medicines safely by staff who were trained and had undertaken competency checks.

People were supported by staff knew people’s latest care needs. Staff reflected on their practice at regular informal and formal supervisions.

People told us and records showed that they were regularly involved in commenting on their care and choosing how they wanted to be supported.

People who required support to eat and drink said they were happy with the assistance they received. Staff knew what people liked to eat and drink.

People were supported to make use of the services of a variety of health professionals to receive the appropriate care promptly when needed.

People’s relatives told us that the registered manager and staff were caring. People were supported by the same staff who they liked.

People were approached to comment on the care they received and staff respected their wishes. People told us that the members of staff respected their privacy and independence.

People told us they felt comfortable to complain if something was not right. The registered manager had clear policies and procedures for dealing with complaints.

The registered manager had taken effective action to address concerns from our last inspection and understood their responsibilities to the Commission.

Staff told us that the registered manager and care co-ordinator were supportive and led the staff team well. Staff stated they enjoyed working at the service for several years.

There were systems in place to ensure people were involved in commenting on their care plans and influence the service they received.

The inspection took place on 28 January 2016 and was announced. At our last inspection in December 2013 the service was complaint with all the regulations we looked at.

The service provided domiciliary care to six people in their own homes. There was a registered manager at this location. 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 and associated Regulations about how the service is run.

People told us that they felt the service kept them safe. Staff knew how to protect people from the risks presented by their specific conditions, however these details were not always included in people’s care plans.

There were enough staff to keep people safe and to meet their needs. People confirmed that they were always supported by the number of staff identified as necessary in their care plans. The registered manager conducted checks when staff joined the service however they did not always conduct regular checks to see if staff remained suitable to support the people who used the service.

People who required assistance to take their medication said they were happy with how they were supported. Staff were able to explain how they supported people to take their medication in line with their care plans.

Staff had the skills and knowledge they needed to meet people’s care needs. Staff received regular observations of their practice and supervisions to ensure they remained competent to support people in line with their care plans and best practice.

People were involved in reviewing their care and had consented to how it was delivered. Staff knew how to support people in line with these wishes, however this information was not always easily identifiable in people’s care records.

People told us that staff supported them to eat and drink enough to stay well. Staff knew what people liked to eat. People had access to other health care professionals when necessary to maintain their health.

All the people we spoke with said that staff were caring and were happy to be supported by the service. People had developed positive relationships with the staff who supported them and spoke about them with affection. Staff knew the appropriate action to respect people’s privacy and dignity.

People told us the service would respond appropriately if their needs and views changed. We saw that records were updated to reflect their views.

The provider had systems in place to support people to express their views about the service and people were aware of the provider’s complaints process. People felt their concerns were sorted out quickly without the need to resort to the formal process.

The registered manager had clear views of how they wanted to develop and improve the quality of the service. All the people who used the service and staff we spoke with expressed confidence in the management team’s ability to lead the service.

The provider had processes for monitoring and improving the quality of the care people received which included observational audits of how staff provided care to people in their own homes. The registered manager reviewed incidents and comments for trends, although this was not always recorded, in order to identify if the quality of the service was improving.

When we visited the agency office, Care Packages UK was providing care to 18 people living in their homes. We spoke with the registered manager and care co-ordinator. We looked at records and spoke with four staff members that provided care to people. We also spoke on the telephone with two people who used the agency and with three relatives of people who used the agency.

People who used the service were involved in planning their care. They were supported to make choices about the care they received. A member of staff told us, “I tell them what I am planning to do and they will tell me if it’s OK.”

People, or their relatives, told us they were happy with the support the staff provided and that it met their needs. A relative of a person who used the service told us, “The staff are very good. It’s the same people and they know what [person’s name] wants.”

The provider had robust recruitment procedures in place to ensure that people employed at the service were of good character and had the necessary skills, qualifications and knowledge to meet the needs of the people who used the service.

We saw that the provider supported the people who used the service and their relatives to comment on the quality of care people received.

People were protected from the risks of unsafe or inappropriate care and treatment

because records were kept up to date and could be easily accessed.

When we inspected the service some people who received the service were not able to give us their views because of their complex needs and conditions. We used a number of methods to understand their experience of the service including speaking with their relatives, looking at care records and speaking with care workers.

People told us that the workers caring for their relatives had a good manner, respected people's dignity and spoke to them as adults. One person who used the service told us they found the staff, “Very caring and conscientious”.

Care was planned and designed to meet the individual health and welfare needs of the people who used the service. A relative we spoke to expressed confidence that their relative’s care was planned, managed and delivered with dignity in the way that was promised.

We saw that the provider had made suitable arrangements to ensure that service users were safeguarded against the risk of abuse.

We found that care workers were skilled, qualified and competent to provide people with the care they required to meet their individual needs.

The provider was able to protect people from unsafe care and treatment by regularly assessing and monitoring the quality of the service provided. There were regular review meetings with the manager, people who use the service, their relatives and staff.