Carrolls Care is a care service registered to provide personal care to people in their own homes (domiciliary care). The service specialises in providing a support to people in the local community who live in and around the town of Minehead. We announced our intention to inspect the domiciliary service so we could be sure the registered manager, care co-ordinator, staff and people receiving a service were available to talk to us.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

We found the Caring domain to be Outstanding. The care and support people received was completely creative and flexible. People were always treated with kindness and respect. The registered manager led a team of staff who were highly motivated to offer care that was exceptionally compassionate and kind. Staff supported people and their families and were empathetic to their needs. One relative said “You can see they love [family member]. The way they talk with them, the care they take. They are with me in keeping [family member] home.”

Staff responded to unscheduled emergencies and were the first line of support for some people and their relatives. They understood what was important to people and helped them in whatever way was needed.

People received care that was responsive to their needs because all staff involved in the service understood the importance of knowing people well and continually checking that the support they were providing continued to be what the person required.

People told us they felt safe with the staff who supported them. One person said “I get very good service all round. There are no worries with any of them.” A relative said “I can relax knowing they know what they are doing.”

People received the particular care required to keep them safe in their own homes. They told us about the arrangements in place to enable staff to enter their homes safely and with regard to their privacy and independence.

The provider had systems and processes in place to keep people safe and minimise the risk of abuse. Potential new staff were thoroughly checked to make sure they were suitable to work with people in their own home. New staff were able to shadow experienced staff and did not complete visits to people alone until they felt confident.

People were supported by sufficient numbers of regular staff to meet their needs. People received reliable support from a team they knew. Staff arrived on time and did not let people down.

People were assessed to establish whether they needed or required assistance with medicines. Staff understood the varying levels of assistance that could be offered to people and the importance of clearly recording any medications they prompted or administered to people.

People received effective support from staff who had the skills and knowledge to meet their needs. People and their relatives felt confident that staff were trained and competent to deliver the range of care and support required.

People were supported to see healthcare professionals according to their individual needs. If they became unwell staff would contact family members or were able to call a doctor. When people needed to attend hospital the service offered flexible support by moving the time of their visits.

People only received care and support with their consent. Staff told us they always checked when entering people’s homes that they wanted care and support that day.

People received a range of services according to their assessed needs and personal preferences. People could choose how much care they required. Some people received two visits weekly to assist with a shower. Other people required several visits a day to enable them to stay safely in their own homes. Staff knew people and if they were unwell, or if a family member was away, additional visits could be made on a short term basis.

The service was well led by the registered manager and care co-o

This inspection was announced and took place on 7 December 2015, 8 December 2015 and 10 December 2015. Carroll’s provides personal care services to people in their own homes. At the time of our inspection 35 people were receiving support from the service. 25 people were receiving personal care. Other people received help with cleaning or shopping. This part of the service is not regulated by us and was not part of this inspection. The majority of people received regular short support visits at a time to suit them.

The agency was established by the provider some years ago and provided a service to people in the Minehead area. In May 2015 they moved to an office in the centre of Minehead.

The last inspection of the service was carried out on 18th May 2014 when the service was at the previous location. No concerns were identified with the care being provided to people at that inspection.

There is a registered manager in post. The registered manager is also the provider. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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 told us they felt safe receiving care and support from the agency. One person told us, “What can I say? I am safe because they are reliable. They have always looked after me. I’m happy with the service.” Another person said “I have no worries. They never let you down” Relatives told us they could rely on the service to keep their family members safe.

People were supported by sufficient numbers of staff to meet their needs in a relaxed and unhurried manner. People knew staff who visited them regularly. Staff told us their rotas were well planned and there was sufficient time to get from one care visit to another.

People received effective care and support from staff who had the skills and knowledge to meet their needs.

When people were unwell extra support and care was provided. Staff were pro-active in reporting when people were unwell and after establishing their wishes took action. They communicated with relatives and health and social care professionals so people had appropriate additional care and treatment.

People who used the service were happy with the staff and got on well with them. Everyone we spoke to was satisfied with the care they received and was positive about staff who visited them. Staff were always kind and polite to them. One relative said there had been many occasions when they had been delighted by the kindness shown to their family member by staff who always “went the extra mile.”

People received care that was responsive to their needs and personalised to their wishes and preferences. People were able to make choices about how the service supported aspects of their day to day lives. They or their relatives were able to commission the services required. People were able to choose how much support they required and when it was delivered.

The manager had a clear vision of the service they wanted to supply to people. They provided a service that was reliable and employed staff who were kind and conscientious. There were systems in place to monitor the service supplied to people and to address any issues raised by people.