This inspection took place on 5 and 11 January 2017 and was announced. We gave the provider 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available. At the time of this inspection, the service was providing the regulated activity of personal care to 14 people who lived in their own homes.

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 registered manager was also the registered provider for the service.

The safety of people who used the service was taken seriously and the registered manager and staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.

Staff were very motivated and enjoyed their roles and responsibilities. They were fully supported by the registered manager and a programme of training and supervision enabled them to provide a good quality service to people.

The registered manager ensured that staff had a full understanding of people’s care needs and had the skills and knowledge to meet them. People received consistent support from care workers who knew them well. People had positive relationships with their care workers and were confident in the service. People who used the service felt they were treated with kindness.

People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care package amended to meet their changing needs. The service was flexible and responded very positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.

The provider was committed to continuous improvement. They demonstrated good values and, a desire to learn about and implement best practice throughout the service. The service demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. The provider encouraged people to provide feedback on the service received. The service made changes in response to people’s views and opinions.

We spoke with eight members of staff, three people who use the service and one relative.

People who use the service told us that they were included in decisions made about their care and that they were treated with dignity and respect.

We found that provider had systems in place to promote successful partnership working with other health and social care service providers.

One relative said, “I have no qualms at all; the carers are different but the quality of the care they deliver is very good indeed”.

Carers R Us (Bristol) Ltd had systems in place to promote the welfare and safe care of people who use the service.

A person who uses the service said, “The best thing is you can get them anytime you want and they will help”.

We found that Carers R Us (Bristol) Ltd had systems in place to assess and monitor the quality of the service provided which included seeking the views of people who use the service and their representatives.

People we spoke with told us they were pleased with the care and support they received from the agency. One person said “The staff are very cheerful and polite I am happy with my care”. Another person said “I am extremely happy with the staff they are very accommodating with us”.

We observed that there was a positive and friendly rapport between support workers and the people who used the service when they were providing care and support.

Care and support was person centred and well coordinated. There were regular reviews to ensure that any changes to people's needs were being met. People were involved in the planning of their care and support.

Staff were trained in safeguarding people from harm and had access to policies and information about how to contact the local authority safeguarding team.

We found that staff were trained and supported to deliver care to an appropriate standard.

The agency had an effective system to regularly assess and monitor the quality of the service that was provided to people.

We saw that the agency had effective complaints system in place and complaints people made were responded to.

The people who use the service and their relatives that gave us feedback said the agency staff never missed a visit. With the exception of one relative, we were told that if agency staff were going to be late the office staff would ring them to say the staff were going to be late.

We were told that when concerns were raised with the provider, action was taken to resolve their concerns to a satisfactory level.

We were also told that staff were respectful and knew how to meet their needs. They said the staff used the correct equipment whenever they provided personal care for example, lifting equipment and where appropriate gloves, aprons and hand gels.

We were also told that they felt safe with the staff who provided personal care.

On this occasion we did not speak to people about these outcome areas

What we found about the standards we reviewed and how well Carers R Us was meeting them.