Carers and Companions provides personal care to people living in their own homes in the Ilkley, Burley-in-Wharfedale and Menston areas of West Yorkshire. At the time of the inspection, the service was delivering personal care to 28 people. The service caters mostly for older people although the service was in the process of expanding to offer care and support to younger adults with learning disabilities.

The inspection took place between 7 and 20 October 2017 and was announced.

At this inspection we found the service remained Good overall. We rated the ‘Is the service caring?’ domain as outstanding. This is because evidence from people, relatives and health professionals demonstrated the service was exceptionally caring and staff had ‘gone the extra mile’ to assist people in feeling comfortable and ensure they were well cared for.

Without exception people said staff were kind and caring. Staff and the registered manager demonstrated excellent caring values and were committed to a highly person centred approach, providing companionship as well as care and support. Staff, people and health professionals were able to give examples where they had gone out of their way to support people, undertaking tasks and checks in their own time to make people feel comfortable and ensure their welfare. The service listened to people and made positive changes to the service based on their views.

A registered manager was in place. 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 said they felt safe and secure using the service. Risks to people’s health and been assessed and staff had a good understanding of how to keep people safe. Staff understood how to identify and report safeguarding concerns. We saw concerns were taken seriously by the manager and acted upon to keep people safe. Safe systems of medicines management were in place. There were enough staff deployed with suitable experience and qualifications to keep people safe.

People said staff provided effective care and support. Staff knew people very well and had received a range of high quality and interactive training based on their individual needs and requirements. Staff supported people effectively to eat and stay hydrated. The service worked well with a range of external health professionals to ensure people’s healthcare needs were met. These professionals spoke positively about the service.

People’s care needs were met. Care plans were in place which provided a good level of detail about people’s needs and preferences. The timeliness of the service was good. People reported staff arrived on time each day and the service was very reliable. Staff stayed with people for the allocated call time and completed all care and support tasks.

People, relatives and staff all said the service was well run. The registered manager listened to people and acted on their comments, complaints or suggestions for improvements. A range of audits and checks were undertaken to help assess, monitor and improve the service.

At the last inspection on 18 September 2013, we found appropriate arrangements were not in place for the checking and recording of administered medication. We carried out this inspection to check that appropriate improvements had been made.

Arrangements were now in place to ensure the safe management of medication, which appeared sustainable. The provider had recently updated its policy to make the processes for the management of medication more robust. Clear and detailed risk assessments were in place with regards to each person's medication needs. A clear record of the medications each person was supported with was maintained.

We spoke with two people using the service or their relative. They told us they thought the service they received was very good. One person told us they could not fault them as they were very professional.

A relative told us, "They do everything they can for my relative, and take such good care of them" and "I am grateful for the loving care being given to my relative".

Carers and Companions provides personal care to people living in their own homes in the Ilkley, Burley-in-Wharfedale and Menston areas of West Yorkshire. At the time of the inspection, the service was delivering personal care to 34 people. The service also provides companionship services and assistance with cleaning and shopping to a number of other people however this does not fall under the regulated activity of personal care and regulatory remit of the Commission.

This was an announced inspection which took between 13 and 20 November 2015.

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.’ A registered manager was in place.

All the people we spoke with told us the service provided good quality care. They all told us they were highly satisfied with the service and had no concerns over any aspect of the service. People told us the service was reliable and they had not experienced any missed or unreasonably late calls.

People told us they felt safe and appropriate systems were in place to identify and manage risks to people’s health and safety.

Medicines were safely managed. Risk assessments were in place which detailed the support people required. Medication records we viewed demonstrated staff provided the agreed level of support.

The service operated safe recruitment procedures to ensure staff were of suitable character to work with vulnerable people.

There were sufficient staff deployed by the service to ensure staff were able to visit people at the correct times and provide the agreed level of support.

Care was provided by an experienced staff team. There was a low staff turnover for example 16 out of 22 of the staff had worked at the provider for over 7 years meaning they had developed strong relationships with people. People said care was provided by familiar staff that understand their individual needs.

A range of training was provided to staff. Training was created by the service to ensure it was tailored to staff’s individual needs and was delivered in a creative and interactive way. Staff praised how interesting and varied training sessions were.

People told us they were supported appropriately with food and drink. Where people were at risk of malnutrition, we saw people’s food input was monitored and the service liaised closely with external health professionals.

The service was acting within the legal framework of the Mental Capacity Act (MCA). People told us they were supported appropriately to make choices about their care and support.

People all told us staff were kind and caring and treated them well. They said care was delivered by familiar staff who they had being able to develop good relationships with.

People were supported to express their views about care and support through regular contact with the management who also delivered care and periodic reviews. People said the service listened to them and made changes to it’s service provision where necessary.

People’s needs were assessed and appropriate plans of care put in place. Everyone we spoke with said staff provided the required care and support and it was done to a high standard.

People and staff both spoke positively about the way the service was managed. They all said they felt they could raise any concerns with the management and they would be dealt with swiftly and professionally.

A range of audits and checks were undertaken by management both informally and formally to ensure the quality of the service was continuously monitored.  Where shortfalls were identified such as with staff training and practice, clear and effective plans were put in place to drive improvement.