We undertook an announced inspection of Carers Trust Thames on 31 May 2017.

Carers Trust Thames is a voluntary organisation which provides care and support to carers and people with personal care needs. The agency provides support and personal care to children, younger adults and older people. On the day of our inspection 50 people were using the service.

There was not a registered manager in post. However, an application was being processed at the Care Quality Commission. 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 and relative’s told us they felt people were safe. Staff understood their responsibilities in relation to safeguarding people.

Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified. People received their medicine as prescribed.

People benefitted from caring relationships with the staff. One person said “They (staff) are fine on the whole, I am happy with them”. People and their relatives were involved in their care and people’s independence was actively promoted. Relatives and people told us their dignity was promoted.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage these risks. Staff sought people’s consent and involved them in their care where ever possible.

Staff knew their responsibility under the Mental Capacity Act 2005. One staff member said “It’s about making a decision and recognising some people can make decisions for different things. You don’t assume a person has not capacity, it’s not a blanket assessment. We will work with professional teams and their relative to ensure the person’s best interest is at the forefront”.

There were sufficient staff to meet people’s needs. The service had safe recruitment procedures and conducted background checks to ensure staff were suitable for their role.

People were supported with their nutrition and their preferences were respected. Where people had specific nutritional needs, staff were aware of these and ensured they were met.

People and relatives told us they were confident they would be listened to and action would be taken if they raised a concern. The service had systems to assess the quality of the service provided. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff mainly spoke positively about the support they received from their locality manager and the senior management team. Staff supervision was regular as were annual appraisals. We saw staff meetings took place to provide good communication with staff. Staff told us the management team were approachable and there was a good level of communication within the service.

People and their relatives told us the staff and the service was very friendly, responsive and well managed. People and their relatives knew the management team and had contact details including emergency telephone numbers. The service sought people’s views and opinions and acted on them. Staff comments included; “I love doing my job, the clients and staff are great” and “I am well supported, I am only a phone call away if I need to ask anything”.

Carers Trust Central & South Bucks is a voluntary organisation which provides care and support to carers and people with personal care needs. The agency provides support and personal care to children, younger adults and older people. This inspection took place on the 4th & 16th February 2016. We gave 48 hours’ notice of the inspection to make sure the people we needed to speak with would be available.

The most recent comprehensive inspection of the service was on 13 February 2014. At that time the service was known as Crossroads Care Bucks and Milton Keynes. The service was meeting the requirements of the regulations at that time.

The service had a registered manager. 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 going through a period of transition. This had challenged some longer serving staff as changes to their work practice were introduced. There was no evidence this had adversely impacted upon the care those staff provided. People were positive about the quality of the care they received and the capability of the care staff who supported them. They were satisfied care staff stayed for the time they were supposed to.

Overall people’s safety was maintained and protected. Staff were fully aware of the service’s safeguarding procedure and were able to describe what they would do if they suspected someone was being abused in any way. The service responded appropriately to any safeguarding concerns they became aware of. However, staff recruitment records did not always include documentary evidence of adequate checks being undertaken into prospective staff’s conduct in previous employment.

Staff received the training and support they required to provide a high standard of care to meet people’s needs. Care plans set out clearly how people preferred their care to be provided. People were involved in making decisions about their care.

The provider sought feedback from staff, people who received care, their relatives and from professionals responsible for arranging care. This information was then used to improve the service provided to people.

We found breaches of the Health and Social care Act 2008 (Regulated Activities) regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

We spoke with people who used the service, and their relatives. They told us the agency provided a reliable service, and that people were treated with respect and dignity.

People spoke in positive terms about the quality of care provided by experienced care staff they knew. One person told us, “I can’t fault the carers. They are very kind and helpful, and do as I ask. A relative told us, “The staff are good, and usually on time. If they are not, the office let us know.”

We found that the staff had received appropriate safeguarding training, and all safeguarding processes were in place.

People were cared for and supported by suitably qualified, skilled and experienced staff because the provider had an effective recruitment and selection process. We found that personal development of staff had been supported through a regular system of appraisal and training.

The provider had a complaints policy and procedure in place. Most people who used the service knew how to use this, but few complaints had been raised.

We found people’s needs were assessed and their care and support was planned and delivered in line with their care plan. People we spoke with said that they were consulted with about any changes to their care and support. They said they were able to make decisions and contribute to the care planning process.

The service had a system in place to ensure people were protected against the risk of abuse. People told us they felt safe with the staff who provided them with support and knew who to speak to if they had any concerns.

Systems were in place to regularly assess the quality of service provided.

People told us they were treated with respect and their dignity was maintained. They said they were satisfied with the standard of care provided and staff understood their needs.