Care Plus Essex Limited part of Manorcourt Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats. Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

This inspection started on 03 October 2018 and ended on 04 October 2018. The inspection was announced. At their last inspection on 10 August 2015, we found one area that required improvement. The service did not have a robust process in place for missed calls and not all staff had their competency assessed following their medicines training. At this inspection, we found they now met all the standards.

There was a manager at the service who had been in post for five months. The manager had applied to be registered with the Care Quality Commission (CQC) as manager. A registered manager is a person who has registered with the CQC 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 received their medicines safely and staff competency was assessed prior to them administering medicines. People were supported by sufficient numbers of staff to ensure risk of harm was minimised. The new manager had reduced missed calls and was monitoring this proactively.

Potential risks to people had been assessed and managed appropriately by the manager. Staff had been recruited appropriately and had received relevant training so they were able to support people with their individual care and support needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to maintain a healthy diet, which considered their culture, needs and preferences, so their health was promoted, and choices could be respected. Access to healthcare professionals was supported.

There were positive relationships between people and members of staff. Staff treated people with kindness and took the time to get to know them and their interests whilst providing their care. The service had involved people in developing their care plans to ensure care was provided in the way they wanted it to be.

The provider had effective auditing systems in place to monitor the effectiveness and quality of service provision. People's views on the quality of the service were gathered and used to support service development. People using the service, their relatives and staff were confident about approaching the manager if they needed to.

Further information is in the detailed findings below.

The inspection took place on the 10 August 2015 and was unannounced. This service was last inspected in January 2014 and was found to be meeting all the required standards. Since the last inspection the provider has re-registered as a new legal entity and changed their address. This is the first inspection carried out since these changes had taken place.

The service provides care to people in their own homes either by providing short visits to assist with personal care and, or domestic tasks or to provide live in care.

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.’

The service was well executed and people were happy with the service they received. The manager was proactive in terms of auditing the service and asking people about their experiences to enable them to address any areas of concern.

The main concern people expressed was about the changes to their regular carers and the timekeeping of their visits. However staff told us they mainly had regular rounds and time to make their scheduled calls. We found that there has been a large number of missed calls since the last inspection which meant we were not assured that people always received a safe service although we did recognise that action had recently been taken to improve the reliability of the service.

Staff knew how to report concerns and were confident in doing so to safeguard people in their care.

Risks to people’s safety were eliminated as far as possible as people’s needs were assessed and staff were supported through adequate training and had policies to follow. Medicine practices were robust.

The service had robust recruitment processes to ensure only suitable staff were employed. Once staff were employed they were supported through a good induction process to ensure they had the necessary skills to deliver care effectively.

There were systems in place to ensure staff’s conduct and practice was of a consistently high standard.

Staff had enough understanding of how to support people and to involve people in their care and seek their consent for different aspects of their care and support.

Staff met and monitored people’s health care and dietary needs. They had enough training to enable them to provide individualised care.

The service was responsive to people’s individual needs and staff were sufficiently knowledgeable and caring about people. People’s care plans reflected people’s preferences and choices and people told us staff respected these.

People were consulted about their care and involved in the review of their needs and asked about the service provided to them.

The service was based on an individual assessment of the person’s needs and could be flexible as people’s needs changed.

Complaints were responded to and there was a clear procedure so people would know how to raise a concern and what they could expect from the service.

This was a well led service with a knowledgeable manager and people who felt the service was flexible and responsive to their needs.

There were audits in place to determine how well the service was being delivered which took into account people’s views so the service could be adjusted accordingly.