Carers Choices provides short term respite care, domiciliary care and home support to people who live in their own homes. The service provides care in the geographical areas of Southend, Rochford, Rayleigh, Castle Point, Basildon and Maldon and surrounding areas. At the time of our inspection, 48 people were using the service. Of those 48 people, 15 received a regulated activity. We only looked at the service for people receiving a regulated activity.

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 ongoing 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.

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.

The service was safe. There were safeguarding procedures in place to protect people from harm and abuse. Individual risks to people had been identified, managed and reviewed. Where required, people were supported to take their prescribed medicines safely. Safe recruitment procedures were in place to ensure staff were suitable and of good character prior to them starting work. There were sufficient numbers of staff to meet the needs of people using the service, and people received care and support from a consistent team of staff. There were systems in place to monitor incidents and accidents. People were protected from the risk of infection.

The service was effective. Newly appointed staff received an induction to ensure they had the knowledge required to meet people’s needs. Staff received on-going training, support and supervision to ensure their skills and knowledge were kept up to date. Where required, people were supported with their dietary needs and with access to healthcare services. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

The service was caring. People received care and support from staff who were kind, compassionate and caring. People's privacy and dignity was respected and maintained at all times and their independence promoted. People and, where appropriate, their relatives were involved in the planning and review of their care.

The service was responsive to people's needs. Care plans contained information regarding people's preferences and individual needs and how people wished to be cared for. Care plans were reviewed regularly, or as and when people's needs changed. There were appropriate procedures in place for dealing with concerns and complaints.

The service was well-led. Staff were well supported and valued by the registered manager and shared the registered manager’s philosophy of promoting a positive person-centred culture. People and relatives were complimentary about the service and felt the service was well led and managed. There were systems and processes in place to monitor the quality of the service and to understand the experiences of people who used the service.

Further information is in the detailed findings below.

This inspection took place over a number of days and these included 28 January 2016

and the 4, 22, and 25 February 2016.

Carers Choices provides short term respite care, domiciliary care and home support to people who live in their own homes. They provide care in the geographical areas of Southend, Rochford, Rayleigh, Castle Point, Basildon, Maldon and surrounding areas.

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.

Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe. Systems were in place to assist people with the management of their medication and help ensure people received their medication as prescribed.

Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff told us that they felt well supported to carry out their work and had received regular supervision and training.

There were sufficient numbers of staff, with the right competencies, skills and experience available to help meet the needs of the people who used the service.

People were supported by staff to maintain good healthcare and where needed they would assist them to gain access or contact a range of healthcare providers, such as their GP, dentists, chiropodists and opticians.

People had agreed to their care and asked how they would like this to be provided. People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner. Assessments had been carried out and care plans had where possible been developed around each individual’s needs and preferences.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

The service had an effective quality assurance system and had regular contact with people who used the service. People felt listened to and that their views and opinions had been sought. The quality assurance system was effective and improvements had been made as a result of learning from people’s views and opinions.

Our inspection team was made up of an inspector to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

The inspector gathered information from people using the service by telephoning them. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were clear and staff understood how to safeguard people they supported.

People told us that they felt their rights and dignity were respected.

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and were fully involved in decisions about their care and lives.

Recruitment practice was safe and thorough policies and procedures were in place to make sure that unsafe practice was identified and people were protected. Staff we spoke with said they had been properly recruited and trained.

Staff told us that they received very good management support in their roles which helped them to provide a caring and responsive service.

Is the service effective?

There was an advocacy service available if people requested it, this meant that when required people could access additional support.

People’s health and care needs were assessed and they were involved in their plans of care.

People thought that their care plans were up to date and reflected their needs.

Is the service caring?

We spoke with people being supported by the service. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example; “The staff are on time and we nearly always have the same person”. “The staff from Carers Choices are all very good”. “The manager visited us recently to update our care plan and we were asked for our views and opinions on the service”. “I’m completely satisfied with the service I receive from Carers Choices”.

People using the service, their carers and relatives completed an annual satisfaction survey. If shortfalls or concerns were raised these would be taken on board and dealt with.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

One person using the service told us, "Staff will do what I ask them, they are flexible in how they support us". Another person said, "When we started receiving a service we were given information on how to make a complaint but we have never needed to complain". People knew how to make a complaint if they were unhappy. No complaints had been received since we last inspected the service. People could be assured that complaints would be investigated and action taken as necessary.

The service worked well with other agencies and services to try to make sure people received care in a coherent way.

Is the service well-led?

The service had a quality assurance system. Records showed that identified problems and opportunities to change things for the better would be taken note of and addressed. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the aims and ideals of the service. This helped to ensure that people received a good quality service at all times.

People who use the service were positive about the care they received. They all confirmed that they had been involved in decisions on how they wanted their care provided and they had regular contact with the manager and staff to ensure that their care needs had not changed. They had all been fully involved in setting up their programme of care.

The people receiving care were complimentary about the staff and expressed that they were happy with the care and support. People we spoke with did not raise any concerns about the care they received and their comments included “We always have regular carers,” “Very professional,” and “Can’t fault the service.”

People using the service told us that they had been in contact with management and that they were able to express their views about the service. They had been made aware of the complaints procedure and received written documentation during the assessment process.

People told us they felt safe and protected by the care workers who were providing support to their relatives and that regular quality checks were in place to ensure the service was meeting their needs.

People who received a service were positive about the care and service. They all confirmed that they had been involved in decisions on how they wanted their care provided and they had regular contact with the manager and staff to ensure that their care needs had not changed. They had been fully involved in setting up their programme of care.

The people receiving care were complimentary about the staff and expressed that they were happy with the care and support. People we spoke with did not raise any concerns about the care they received and their comments included “They are always there on time,” “They are consistent in staffing,” and “I would recommend them.”

People told us they felt safe and protected by the care workers who were providing support to their relatives and that regular quality checks were in place to ensure the service was meeting their needs.