This inspection took place on 5 and 9 January 2017 and was announced.

Bramley is a domiciliary care agency providing personal care for people in their own homes. There were 140 people using the service at the time of the inspection. Half of the people receiving the service were living with dementia. Services are provided from their main office in Bramley and a satellite office in Chertsey.

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.

People had up to date risk assessments for fire, the environment, medication and moving and handling. However, we found some people did not have risk assessments for identified risks of malnutrition, dehydration or pressure sores. However the registered manager took immediate action to improve this and make sure these were in place to guide staff.

There was a risk that people’s rights would not be protected because not all staff had good knowledge of the Mental Capacity Act 2005 (MCA) and MCA assessments were not decision specific. However the registered manager took immediate action to improve the form that was used and to arrange further staff training.

People and their relatives told us that they felt safe and staff had a good understanding of how to keep people safe.

There were sufficient staff to meet people’s needs. The service used an electronic business management system that records and monitors staffing availability, consistency of carer, travel time and the service being provided to people. The service followed safe recruitment practices.

People benefited from a safe service where staff understood their safeguarding responsibilities. The provider who was the safeguarding lead for the agency.

The provider had developed plans to help ensure that people’s care would not be interrupted in the event of an emergency, such as loss of utilities or severe weather.

People’s medicines were managed and administered safely. Staff received training every year and a competency check every six months to ensure they were able to support people to take their medicines safely.

People received individualised care from staff who had the skills, knowledge and understanding needed to carry out their roles. Staff had received induction training which included completing the care certificate and shadowing more experienced staff. Staff received refresher training to help ensure they remained up to date with best practice and training to enable them to meet people’s specific needs.

People were supported by staff who had supervisions (one to one meetings) and an annual appraisal with their line manager.

The staff met people's dietary needs and preferences and people’s health care needs were monitored and any changes in their health or well-being prompted a referral to their GP or other health care professionals.

People and their relatives told us that staff were caring and they were happy with the care they received, and staff told us they really cared about people and what was important to them.

Staff treated people with dignity and respect, and people were encouraged to be as independent as possible.

When people first received a service they were always introduced to the care staff who were going to support them. People knew which staff were going to provide them with support and when, and the same care workers were provided consistently.

People’s views were sought through care reviews and customer surveys.

Care, treatment and support plans were personalised and detailed. People and their relatives were involved in developing them and were in control of their care.

Assessments covered people’s needs and captured important person centred information and people