Care Services is a small domiciliary care agency that supports 13 people in their own homes with personal care . Care Services support older and younger adults with a range of needs including people living with dementia and people who have physical disabilities. We visited the office of Care Services on 26 May 2017. We last inspected this service on 9 March 2015 and rated the service as Good. At this inspection we found the service remained Good overall with an Outstanding rating for Caring .

There was a registered manager in post who was also the provider. 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 .

People described care workers as very kind. People had developed meaningful relationships with the care workers who provided their support. Care workers understood the importance of respecting people's dignity and supported them to make decisions about how they wished to live their life. The registered manager and care staff demonstrated their commitment to providing outstanding support to people to maintain and develop new relationships.

Pre-employment checks were completed for all new staff to check that they were suitable to work with people who used the service. There were enough staff employed to meet people's needs and to attend each call.

People were kept safe by care workers who had received training on how to recognise and report any suspected abuse. Risks related to people's care were identified and procedures were put in place to minimise the risks. Procedures were in place to support people safely when they took their medicines.

Care workers received training to support people effectively. The registered manager understood the principles of the Mental Capacity Act 2005 and care workers understood the need to gain people's consent before providing care. Referrals were made to health and social care professionals when needed to make sure people received the support they needed.

People worked in partnership with the staff to plan their care and this was continually reviewed to meet their needs. Care workers had good knowledge of people's preferences and offered people choices.

People knew how to raise concerns and felt confident to do so. No complaints had been received by the service in the 12 months prior to our visit.

Care workers received support from the registered manager to deliver high quality care.

People had opportunities to give their feedback about the service they received. The feedback was analysed to make sure the service continued to meet people's needs. The registered manager completed regular quality assurance checks to continually improve the service people received.

This inspection took place on 9 March 2015. The inspection was announced. The provider was given four days’ notice of our inspection. This was to ensure the registered manager was available when we visited the agency’s office, and staff were available to talk with us about the service. At the last inspection on 9 January 2014 we found there were no breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008.

Care Services is a small domiciliary care agency which provides care for people in their own homes. Some people received support through several visits per day, for a few hours per week, and some people were receiving support 24 hours a day. On the day of our inspection the agency was providing support to 13 people.

A requirement of the provider’s registration is that they have 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run. At the time of our inspection there was a registered manager at the service.

People and their relatives told us they felt safe using the service and staff treated them well. Staff understood how to protect people they supported from abuse. People and their relatives thought staff were kind and responsive to people’s needs.

Management carried out regular checks on care staff to observe their working practices and to ensure records were completed accurately. There was an out of hours on call system in operation, this ensured management support and advice was always available for staff.

Staff were well trained and could meet the complex needs of people they cared for.

Management and staff understood the principles of the Mental Capacity Act 2005 (MCA), and supported people in line with these principles. Where people had been assessed as not having capacity, best interest decisions had been taken on their behalf.

People told us they knew how to make a complaint if they needed to. They were confident that the service would listen to them and they were sure that their complaint would be fully investigated and action taken if necessary.

Staff, people and their relatives felt the management of the service was open and transparent. Positive communication was encouraged and identified concerns were acted on quickly.

The vision and values of the service was to encourage independence, respect and dignity.

There were procedures in place to check the quality of care people received, and where systems required change the provider acted to make improvements.

At the time of our inspection Care Services had ten people who used the service. One received 24 hour care and the others had a variety of calls throughout the day. They had fifteen care staff.

During our visit we spoke with the registered manager and two care staff. After our visit we spoke by phone with two people who used the service; relatives of two people who used the service and with two care staff.

People who used Care Services and their relatives told us that care and support needs had been agreed with them before the care started. We were told copies of care plans were available in people's homes. A person who used the service said: “They are excellent in every way.” A relative told us: “They are the best we have used by far.”

The files we looked at contained care plans that were personalised and included people's preferences. People told us care staff were able to do everything they needed within the allocated time. They also said staff took their time and did not rush. One person who used the service said: "We are so pleased with them.”

All people we spoke with told us care staff were friendly and helpful; supported people in the way they preferred and respected their opinions.

Records showed the agency had systems in place to monitor the care provided and for managing identified risks. People who used the service and relatives said they were happy with the care they received.

People told us that their care and support needs had been agreed with them and their family when the service started. We were told copies of care plans were available in people’s homes. People told us that care staff respected their privacy during personal care routines.

One person told us, “Compared to previous agencies, they are brilliant. The difference has been amazing.” Another person said, “They are very good at everything they do”

The files we looked at contained care plans that were personalised and included people’s preferences.

People told us care staff were able to do everything they needed. They also said that care staff did things in the way they preferred and respected their opinions. One person said, “I don’t feel intimidated or that they take over.”

Records showed the agency had systems in place to monitor the care provided and for managing identified risks. People said they were happy with the care they received. One person said, “There is never a problem with carers not turning up.”

People told us that staff were pleasant and helpful. People told us they felt safe with staff.

Care Services provides excellent quality care to a small number of people in the Solihull area who have complex physical disabilities and very specific needs. Care is provided by a dedicated professional staff team who are overseen by a senior management team and led by a competent, highly experienced provider.

People using the service were very happy with the care they received from Care Services. Comments and compliment letters we saw told us the carer’s were excellent, very friendly and helpful. They said they had no complaints and were more than satisfied with the service. Comments included: ‘I am very happy with my present carers and feel very comfortable with them’ ‘Excellent carers, very professional’.

The senior management team reviewed each person’s care documentation on a monthly basis. They spoke to the person and their family to make sure the service provided was of a good standard, and was meeting the needs of the individual.

As part of this review we also spoke to other professionals such as social workers who used the services provided by Care Services for their clients. They told us: ‘I breathe a sigh of relief when I know they are caring for my client’ ‘They assess the needs of the client very well and provide an excellent service’.

People who used the service felt well supported by friendly, professional staff.

People who used the service felt comfortable with talking to the manager or any member of staff if they felt things could be improved. They were very satisfied with the service provided.