Care South Home Care Service is a domiciliary care agency providing personal care and support to people living in their own homes. Not everyone using the service receives a 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.

At the time of the inspection 197 people were receiving the regulated activity ‘personal care’.

This inspection was announced and took place on 21, 22, 23 and 26 March 2018.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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Why the service is rated Good.

The service continued to provide safe care and support for people. There were adequate numbers of staff to provide the care and support people needed.

People were protected from abuse because the provider had systems in place to ensure checks of new staff, and their suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse.

People said they felt safe when being cared for; we observed people were happy and relaxed with staff during our home visits. All incidents and accidents were monitored, and learning was shared with staff to put into practice.

The service continued to provide effective care and support. People were supported by staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. Most people said they had a regular team of staff who they knew and had built relationships with. We observed staff took time to talk with people during our home visits.

People were supported by staff who were highly motivated in their role and went over and above their job role to maintain people’s comfort, well-being and happiness. People told us the staff were kind, caring and they were treated with dignity and respect. We observed caring interactions during home visits.

The service had improved their rating in responsive to good. There were improved systems in place to inform people of any changes to their staffing. Records showed the service responded to concerns and complaints and learnt from the issues raised.

People's care needs were recorded and reviewed regularly with the person receiving the care or a relevant representative. Staff had information and guidance in care plans to enable them to deliver consistent care the way people preferred.

The service continued to be well led. There were effective systems in place to manage the service.

The registered manager worked with a management team with clear areas of responsibility for planning, staffing and client services.

There were systems in place to monitor the care provided and people's views and opinions were sought through care reviews and an annual survey.

Further information is in the detailed findings below.

The inspection was announced and visits to the service took place 14 and 27 April. We made telephone calls to people using the service from 17 May 2015 to ask them their views of the care they received.

Care South is a domiciliary care agency providing personal care and support to people living in their own homes and in sheltered accommodation. At the time of the inspection they were providing a service to approximately 420 people. The majority of people received personal care. Some also received a shopping or domestic cleaning service. These activities are not regulated by us and did not form part of the inspection.

There were systems in place to manage this large service. The registered manager worked with a management team with clear areas of responsibility for planning, staffing and client services. Five geographical areas had designated planning staff to arrange people’s care visits and allocate care staff. A team of supervisors monitored delivery of care and supported staff.

The Independent Living Team assessed clients and provided care for people who had just come out of hospital or commenced receiving care. As part of a multi-disciplinary team they worked with physiotherapists, social workers and occupational therapists to ensure people were safe at home. Some people required care for a short period before regaining their health. Others required long term care which was provided by the core (main) care staff. A night response team enabled some people to have planned and emergency support during the night. The service cared for some people until the end of their lives and had implemented the Gold Standards Framework for domiciliary care.

There is 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 registered manager had a clear vision for the service. There was a commitment to provide high quality care tailored to people’s individual wishes. These values were communicated to staff through staff meetings, training and supervision.

People told us they felt safe with all the staff who supported them. There were risk management assessments and plans in place which meant care was provided in a manner that kept people as safe as possible whilst promoting their independence and choices. People received care and support in line with their needs and wishes because adequate numbers of staff were employed.

The agency recruited staff regularly to maintain staff numbers and meet peoples changing needs.

There were systems in place to monitor the quality of care and plan on-going improvements. People were contacted on a regular basis through telephone calls and visits to ensure they were satisfied with the care they received.

Most people told us they had some regular staff visiting them most of the time. The service was working to improve the continuity of staffing and had implemented measures to improve the planning of staff visits. However half the people we spoke with said the timing of visits could be improved. People did not tell us staff missed visits but they often did not arrive when expected. Some people accepted this but others found it very difficult and were not satisfied.

Most people were very positive about the other aspects of the service they received from Care South. They received care following the assessment of their needs and had their care reviewed and varied if their health or social circumstances varied. People received effective care and support from staff who had the skills and knowledge to meet their needs. Care staff were supported through the effective organisation and delivery of training, observations and supervision meetings.

People found staff to be kind and caring towards them. There were many positive comments about staff that showed they understood the importance of their role in supporting people and maintaining people’s independence and dignity.

People were able to make complaints or raise issues about any aspect of their service. People were encouraged to express their views and be involved in the planning of their care. A senior manager was dedicated to sort out any problems and resolve concerns.

The manager of the service led a team of staff who were clear about the standard of service they wanted to deliver. There were plans in place to further develop aspects of the service in the way people had requested.

People received a good quality of care and support. Care records were person centred and reflected each person’s needs and preferences.

Families were encouraged to be involved where the person wished it. Relatives we spoke to told us they were included in the planning of their care. One person told us they “ask me everything, so all the staff do things as we like it”.

We spoke with three relatives of people who used the service, all of whom were complimentary. One person told us the staff were “kind hearted”. Another person told us “I’m more than happy with them, totally professional and first class”.

Staff we spoke with were knowledgeable and caring in nature. They were able to describe their roles in supporting people in respectful ways. One staff told us they had received "a lot of relevant training" that helped them support people "to the best of my abilities".

Staff told us they felt supported by the service. One staff told us “they are the best I’ve ever worked for”.

Staff were knowledgeable about keeping people safe. Family members we spoke with told us their relatives felt safe with staff in their homes. One person told us they were "confident to talk to staff if they had any concerns". One relative told us the staff were “very easy to talk to” and “know Mum well enough to know if something's wrong”.

People who used the service were very positive and were unanimous in agreeing that they were treated with respect and dignity and they looked forward to the visits of the carers "as it brightens my day".

We observed that the relationships between the people and their carers were enhanced by the use of life stories in their care plans, as this helped the carers to communicate in a more individualised and meaningful way with the people for whom they were caring and supporting.

People we spoke with told us that they had good relationships with staff and said that they "felt safe" when the carers visited them in their homes and were able to express their wishes and concerns and know that they will be listened to.

People told us that they felt involved in the decision making around their care and support needs in their homes and reported that the staff often did that little bit extra for them such as helping with their shopping in their own time and buying cakes to celebrate a person's birthday.

People made positive comments about the staff when they contacted the office to make changes around their visit times,” staff are always helpful and polite and make the changes to my visits as soon as they possibly can" One person told us "that nothing is ever too much trouble for the staff when I ring them up and knowing that is very reassuring for me and my family".