What life is like for people using this service:

People who received care from Catto Homecare told us they felt safe and supported by staff who visited them. Staff were punctual and consistent at carrying out visits with people in a person-centred manner. One person told us, “I’m very satisfied. They are very caring, very professional.” A second person said, “They do as I ask every day. They turn up on time.”

People told us that they were visited consistently by the same staff who were well trained and experienced. Where needed, staff were quick to support people to have access to health care professionals such as occupational therapists or, when necessary, emergency services.

People and relatives described staff as caring and kind towards them. Staff were approachable and friendly with people they cared for and knew them well.

Care plans were created with people and relatives to ensure they were person centred and tailored to peoples’ needs and routines.

The service was well managed by a supportive and progressive management team. People, staff and relatives were involved in helping the service improve.

More information can be seen in the main body of the report for each Key Question below.

Rating at last inspection:

Good (20 June 2016)

About the service:

Catto Homecare is a domiciliary care agency that was providing personal care to 15 people aged 65 and over at the time of the inspection.

Why we inspected:

This was a scheduled inspection based on the previous rating. We inspect all services rated as 'Good' every 30 months to ensure that we regularly monitor and review the quality and safety of the service people receive. At the last inspection we found that medicines were not being audited and people’s mental capacity was not being assessed. We also found that some quality assurance checks were not effective or robust.

At this inspection we found that medicines were being audited and people’s mental capacity was being assessed when necessary. We also found that quality assurance checks were effective at driving improvement and ensuring high standards.

The inspection was announced and took place on 31 May 2016.

Catto Homecare is a small domiciliary care agency that provides personal care to people in their own homes in Camberley and the surrounding areas. People who receive a service include those living physical frailty or memory loss due to the progression of age. At the time of this inspection the agency was providing a service to 14 people. The frequency of visits ranged from one visit every fortnight to full time live in care 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.

Everyone that we spoke with, without exception, expressed satisfaction with the service they or their family member received. They said that care workers arrived on time and would stay longer than the allocated time if required to ensure their needs were met. People spoke very highly of the registered manager and care workers.

The safety of people who used the service was taken seriously and the registered manager and staff were well 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.

Procedures were in place to ensure people’s rights were upheld if they lacked the capacity to consent but at times these were not followed in full. Some people’s relatives had consented to care being provided by the agency without the agency having obtained evidence they had the legal right and authority to do this. We have made a recommendation about this in the main body of our report.

People were happy with the support they received to manage their medicines. We did note that the agency was not following its medicine policies and procedures in full. We have made a recommendation about this in the main body of our report.

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 felt safe and secure when receiving care. Recruitment procedures ensured care was provided by staff who were safe to support people in their own homes.

Staff were very highly motivated and proud of the service. They said that they were fully supported by the registered manager and a programme of training and supervision that enabled them to provide a high quality service to people.

People had positive relationships with their care workers and were confident in the service. There was a strong emphasis on key principles of care such as compassion, respect and dignity. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.

People received a service that was based on their personal needs and wishes. People were happy with the support they received to eat and drink. Changes in people’s needs were quickly identified and their care package amended to meet their changing needs. The service was flexible and responded positively to people’s requests.

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.

The registered manager was committed to continuous improvement and feedback from people, whether positive or negative, and this was used as an opportunity for improvement. At the time of our inspection formal quality assurance systems were not being used to monitor the quality of service provided by the agency. We have made a recommendation about this in the main body of our report.

We found evidence of consent being sought from the initial contact with the service through the baseline assessment process. Care plans, which included a risk assessment, were signed by the person and their relatives.

The service had a comprehensive range of policies instructing staff how to manage difficult situations. These included fire, gas leaks, water and flooding, electrical failure, bogus callers, heat waves, ill health and aggression from people who use the service.

People who use the service had a full assessment of their needs undertaken by the manager before care provision began. The manager told us that they actively sought to involve the family members and ask for input from other professionals such as the GP and social services.

The manager had systems in place to supervise, train and assess the practice of the staff. There was an open and proactive approach to care. We noted the level of communication between staff was clear and detailed.

Relatives told us that the quality of care was very good, that they were involved in all decisions and discussions and the company was responsive and forward thinking. One relative told us that “the level of care is fantastic. They help my relative maintain her life, independence, personality and character”. They expressed that they trusted the manager and that the staff were well qualified and lovely people.

As part of our inspection we spoke with three people whose relatives were receiving care from Catto Homecare.

All three people told us the service was very good and that they were very happy with the way their relatives were being cared for.

One person we spoke with told us the service went ‘the extra mile’ and that was of a ‘very good standard’. They told us that the staff were very good at identifying problems and coming up with solutions to these. They told us they were in very frequent contact with the service’s manager who they thought was ‘exceptionally good’.

A second person we spoke with told us they thought the service was ‘excellent’ and that they and their relative were ‘very happy’. They told us they felt encouraged to be involved and were always given a lot of information about their relative’s care. They told us they thought the manager was ‘brilliant’ and that there was ‘constant communication’ between them.

A third person we spoke with told us they thought the service was ‘absolutely wonderful’. They told us they believed the staff’s knowledge on dementia was ‘fantastic’ and that the ‘care and detail was phenomenal’. They told us the service went ‘above and beyond’ and was ‘amazing’. They told us they were given lots of information throughout their relative’s care and were always given copies of case notes. They told us that they believed the quality of care their relative was receiving was ‘phenomenal.