The inspection was announced and took place on 21 December 2018. This was because this service provides care to people in their own homes and we needed to ensure senior staff were available to speak with us.

Care South is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection, the service was providing support for 151 people.

A registered manager was in post at the time of our inspection. 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.

Care South was previously inspected on 6 June 2016. The overall rating for the service was good.

Systems were in place to keep people safe. People’s medicines were managed and administered safely. Staff were recruited following the provider’s recruitment policy. People received care and support on time and as agreed.

Staff were passionate about supporting people in making their own choices and decisions. People were involved and consulted about their care and support. Care plans provided guidance for staff about people's needs and the way they preferred their care to be provided.

People were involved in planning their care and are records had been reviewed and updated where necessary. When peoples care needs had changed, the service engaged and worked with the appropriate Health and social care professional.

People were supported by staff who were trained, competent and had received training to provide care and support to people. Staff felt supported and received supervision and an annual appraisal.

People were supported to receive their medicines safely and when required and staff could demonstrate the correct use of personal protective equipment to prevent cross infection.

People were supported by staff who had suitable checks in place prior to being employed by the service.

Staff were able to demonstrate a good understanding of abuse and who to go to should they have concerns.

People were supported by regular staff who knew them well including their likes and dislikes and they respected their routines. Staff were kind and caring and offered people choices.

People received support from staff as required with their food and drinks. People and relatives felt able to raise concerns with the registered manager and all felt they were accessible.

Staff were recognised for their individual contribution to the service and support they provided people with. Staff had access to the training they needed to carry out their roles.

People's nutritional needs were assessed during their initial assessment and any dietary needs recorded in their care plans. Staff understood people's healthcare needs and supported them to maintain good health.

Staff were kind and caring. People had developed positive relationships with staff members and enjoyed their company. Relatives said staff treated their family members with respect and maintained their dignity when providing care. Staff supported people to maintain their independence wherever possible.

The agency was not providing end-of-life care at the time of our inspection. The provider had an end of life care policy, which gave guidance to staff if they had to provide care to a person now.

Staff worked in partnership with healthcare professionals, such as community nurses, to provide people's care. People had opportunities to contribute their views about the service they received. People knew how to complain if they were dissatisfied. People who had complained told us action had been taken as a result of the concerns they raised.

A range of audits were undertaken to monitor the quality of the care and the accuracy of records used to record people's care and support. This information was not

The inspection took place on 6 June and was announced. We gave the registered manager 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available at the office.

Care South Home Care Services is a large domiciliary care agency providing personal care to people in their own homes. The service has approximately 96 staff supporting about 155 clients in Bath and surrounding area. The office is staffed five days a week and emergency cover is available after office hours. The service has 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.

Our last inspection on 4 February 2014 found that the provider was meeting all the regulations assessed.

People who used the service and their relatives told us they felt safe and comfortable with the staff team. They told us that they were reliable and communicated with them well. All staff had received training about safeguarding and this was updated every year. The required checks had been carried out when new staff were recruited.

The staff we spoke with had good knowledge of the support needs of the people who used the service and had attended relevant training. The staff we spoke with demonstrated a commitment to providing the support people needed as well as a commitment to protecting people from harm or abuse.

People we spoke with confirmed that they had choices in all aspects of the support they received and benefitted from a personalised approach to care planning.

People who used the service, their families and staff told us that the management team was open, transparent and knowledgeable. People we met during our visits along with those we spoke with on the phone spoke highly of the staff and management team.

The registered manager provided us with a number of methods used to assess the quality of support provided. This included gaining regular feedback from people who used the service and their families or carers and staff.

People told us how well supported they are by the staff who visit them in their homes. Examples of comments made included “it’s wonderful they are all so professional and they are friendly”, “the staff are very polite and very nice”, “the staff are delightful”, and “the service is very, very good”. These comments show that people feel their care needs are met. People told us that they were able to stay in their own homes with the support staff gave them.

People benefited because care plans explained to staff what support they needed clearly and were informative. People who use the service were cared for by staff who had an awareness and good understanding of their needs.

People felt safe with the staff who supported them in their homes. There were systems, practises and procedures in place to protect people from abuse in their homes.

The service actively involved people in monitoring and reviewing the quality of service and the care they received. The service has been run for the best interests of people who use it. It was being run in a flexible way that treated each person as unique. One person said “I trust them all they respect me and they treat me with dignity”.

At the time of this inspection, Care South employed 93 care staff to provide personal care services to 142 people. The manager told us they had a contract to provide personal care to people identified by the local authority. This contract accounted for approximately 85-90% of referrals. Other care packages were arranged thorough individual, private contracts with people.

In order to understand people’s experiences of care, we spoke with four people who used the service and three relatives of people who used the service. We sent out 61 questionnaires to people. Each person was sent an additional questionnaire to give to a relative, friend or advocate for completing. A total of 17 questionnaires were returned to us.

People told us they were happy with the service they received. All of the people we spoke with or replied to the survey told us they were fully involved with their assessments of care and treated with dignity and respect. One person said, “they always talk to me very politely and ask me what I want help with.” Care records were detailed and person centred and included assessments and action plans for carer’s to follow.

People told us they felt safe with the support they received. Staff demonstrated an understanding of how to safeguard adults from abuse. All the staff we spoke with told us the providers training was ‘excellent’. The manager confirmed all staff were in date with the provider’s mandatory training. This included adult protection and safeguarding from abuse training.

Records demonstrated the providers recruitment processes were clear, ordered and well maintained. Each employee had a personnel file which included records of reference and other checks which had taken place prior to employment.

People and their relatives were encouraged to give their views about the service. The agency and local authority both conducted surveys with people in order to identify potential service improvements. People told us they knew how to raise a concern or a formal complaint. The agency maintained records and actions taken in relation to; concerns, complaints, compliments, accidents and incidents.