Carers With Care Ltd is a domiciliary care agency. It provides personal care to both adult and young people living in their own homes. At the time of our inspection 54 people were using the service.

This inspection took place on 9 November 2018; and was announced. The last inspection of the service took place 28 March 2017 where we found a breach of regulation of the Health and Social Care Act relating to good governance as the systems for assessing and monitoring the quality of the service were not effective. The provider sent us an action plan on how they would improve. At this inspection, we found that the service had made the required improvements and had complied with the regulations. We have rated the service Good.

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 provider undertook checks and audits to monitor the service delivered to people and to drive improvements. The provider worked in partnership with other agencies to develop and improve the service. Staff told us that they had leadership and management support needed to do their jobs effectively. The service operated an open culture which encouraged feedback and learning opportunities when things go wrong.

Staff were trained to keep people safe from abuse. They knew the procedure to report any concerns appropriately. People were protected from avoidable harm as risks were assessed and management plans were in place. Staff reported incidents and accidents appropriately and the registered manager took action to address them and to reduce the risk of recurrence.

There were sufficient numbers of experienced staff to support people safely and staff were appropriately deployed to cover care visits. Staff recruited were vetted to ensure they were suitable to work with people. Staff provided people with the support they required to take their medicines safely. The risk of infection was minimised as staff were trained and knew the procedure to reduce infection from spreading.

Staff were trained and supported in their roles. People received the support they required to eat and drink. Staff supported people to maintain their health and to access healthcare services they needed. Staff liaised with other professionals to ensure people’s needs were met.

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 supported this practice. Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005. Staff involved people in their care delivery and obtained consent from people before supporting them.

People received care from staff who were compassionate and caring. People and their relatives were involved in planning their care. People were encouraged to maintain their independence. Staff respected people’s privacy and their dignity. People received care from staff they were familiar with and had developed relationship with. Staff were trained to deliver end of life care in line with people’s wishes.

People had their needs assessed before they started using the service. People’s needs were reviewed and care plans updated to reflect people’s current needs. People received care and support personalised to their needs. The provider made information accessible to people in various formats in accordance with people’s needs and preferences. Care records detailed people’s cultural and religious needs.

People knew how to complain if they wished. The service sought the views of people about the care they received and acted on them.

The inspection was announced and took place on 7 March 2017.

Carers with Care Limited is a domiciliary care agency that provides personal care to people in their own homes in the West Surrey area of Camberley, Frimley, Lightwater, Bagshott and Michett.

People who receive a service include those living with frailty or memory loss due to the progression of age, mobility needs and health conditions such as diabetes. At the time of this inspection the agency was providing a service to 54 people between the ages of 50 to 102. Visits ranged from 15 minutes to one and half hours. The frequency of visits ranged from one visit per week to four visits per day depending on people’s individual needs.

During our inspection the registered manager was present. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 had been in post since October 2016 and registered with CQC since February 2017. The registered manager was committed to continuous improvement and feedback from people, whether positive or negative was used as an opportunity for improvement. However, quality assurance systems were not robust and were not fully embedded or used to drive improvement. As a result, some records were not accurate and staff had not received training in all required areas. You can see what action we told the provider to take at the back of the full version of the report.

People were happy with the service they received and complimented the care workers who supported them. People felt they were treated with kindness and said their privacy and dignity was respected.

People's care and support plans contained information about what was important to them and how care should be delivered. People were involved in reviewing care plans with members of the management team. People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible.

People were generally happy about the timing of their visits but said that improvements could be made of a weekend. The agency was aware of this and had taken steps to make the required improvements.

Care workers knew how to keep people safe. They understood their responsibilities under safeguarding procedures and were confident the management team would act swiftly and deal with any issues appropriately. Recruitment procedures ensured care was provided by staff who were safe to support people in their own homes.

People said that they were happy with the support they received to manage their medicines. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely.

People were happy with the support they received to eat and drink. Changes in people's health care needs and their support was reviewed when required. If people required input from other healthcare professionals, this was arranged.

Complaints and concerns were investigated and responded to appropriately. People who used the service felt able to make requests and express their opinions and views. A formal complaints process was in place that people were aware of.

Care workers were committed and said that the registered manager and the management team were approachable and supportive. Care workers were supported to provide appropriate care to people by a system of supervision that included observations of their practice when in people’s homes. They felt confident with the support and guidance they had been given during their induction and subsequent training.