Celtic Care Services Limited provides a care at home service for adults in Chippenham and the surrounding areas. At the time of our inspection 41 people were receiving personal care from the service.

This inspection took place on 28 September 2017. This was an announced inspection which meant the provider knew two days before we would be visiting. This was because the location provides a home care service. We wanted to make sure the registered manager, or someone who could act on their behalf, would be available to support our inspection.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.

At the last comprehensive inspection in June 2016 we identified that the service was not meeting Regulations 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because personal information about people using the service was not handled securely and staff were not always able to communicate effectively in English. The provider wrote to us to set out the action they would take to address these concerns. At this inspection we found the provider had made the necessary improvements. Personal information was being managed securely and staff were able to communicate effectively.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments included, “Staff have the right skills. They know what they’re doing”, “The staff all know what they’re doing. They do everything that’s in the care plan” and “They arrive on time as a rule and are very good to us. They always do what we ask them to”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.

Staff understood the needs of the people they were providing care for. Staff were appropriately trained and skilled. They received a thorough induction when they started working for the service and demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs. Comments from staff included, “I feel well supported. I have no faults [with the management team]” and “It’s a good place to work. We get good support from the [staff in] the office”.

The service was responsive to people’s needs and wishes. People had regular meetings to provide feedback about their care and there was an effective complaints procedure. People and their relatives felt they could contact the office if needed and they also had contact numbers out of office hours, in case of an emergency.

The provider regularly assessed and monitored the quality of the service provided. Feedback from people and their relatives was encouraged and was used to make improvements to the service.

Celtic Care Services Limited provides domiciliary care and support services to people with individual needs in their own homes. At the time of our inspection 50 people were being supported by this service.

This inspection took place on 28 June 2016. This was an announced inspection which meant the provider had prior knowledge that we would be visiting the service. This was because the location provides a domiciliary care service, and we wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.

At the time of our inspection a registered manager was in place at the service. 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 and the managing director were accessible and approachable throughout the inspection.

Relatives felt that their loved ones were kept safe by the support the received from the service. However not all staff were able to explain how they kept people safe and what action they would take if they thought someone was at risk of harm or abuse. This meant that people could be at risk from inappropriate care if staff did not know the correct procedures to follow in reporting suspected abuse.

People’s private information was not always protected. The service did not have safe systems in place to prevent this information from being accessible to people outside of the service.

Although some safe recruitment checks had been followed this was not always the case. One reference received by email had not been checked for authenticity, the process stated in the provider’s own policy which should be followed. “Not all staff had a record in place to show they had declared themselves as being fit for work and able to take on their role without concerns.

People and their relatives told us there was a communication barrier with staff. We also found this when we spoke with some of the staff who were unable to understand or answer some of the questions we asked. This meant that people who had communication difficulties may experience problems when asking to have their care needs met and for these to be understood.

People were happy with the care they received. Staff told us they regularly supported the same people which allowed for consistency and changes in people’s needs to be noticed more quickly.

The service was responsive to people’s needs and wishes. We saw that people’s needs were set out in clear, individual plans. These were developed with input from the person and received regular reviews to ensure the care delivered reflected people’s changing needs.

The registered managers’ assessed and monitored the quality of care. The service encouraged feedback from people, their relatives and staff, which they used to make improvements. Not all of the concerns we found during our inspection had been identified by these quality monitoring systems.

Two potential notifiable incidents had not been reported to the Care Quality Commission (CQC).The events of these incidents were hard to establish as the initial documentation contradicted the registered managers explanation.

We found two breaches of the regulations. You can see what action we told the provider to take at the back of the full version of the report.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

We spoke with three people who use the service, three relatives, five members of care staff, the registered manager, a director of the service and a supervisor.

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 the provider promoted successful partnership working with other health and social care service providers.

One relative said, “I cannot praise them highly enough; their consistency and continuity of care are absolutely impeccable”.

We found that Celtic Care Services Limited had systems in place to promote the welfare and safe care of people who use the service. A person who uses the service said, “They are all very good, very caring and very kind; I am very lucky”.

The provider informed people who use the service how to make a complaint or raise a concern and had systems in place to investigate and resolve complaints.

We found that Celtic Care Services Limited assessed and monitored the quality of the service provided which included seeking the views of people who use the service and their representatives.

We spoke with seven people who had experience of the agency. This included relatives, people using the service and a professional. We also spoke with three members of staff.

People we spoke with talked of the good communication they had with the agency and that the carers were excellent. Any problems that had arisen had been dealt with promptly. One relative said that they were kept informed and found the staff reliable. Care plans were clearly written and any risks identified and reviewed regularly. One person said that sometimes they felt a bit low but when the carer arrived with a big smile on their face they cheered up.

One member of staff said “I love it” and others spoke with pride about the work they did and were positive about the support they received. There was a system for the recruitment of staff which the provider intended to review to make it more effective. There was also a system for capturing the views of people using services and their relatives. The provider has extended this to include staff and other professionals and this will be introduced shortly.

People told us that the service was very good. Everyone we spoke with said that they were involved in planning their care and received information each week about which care worker would be visiting. Also, that the care workers knew them well and understood their care needs. People said that their care needs had been discussed and agreed. Their care plans were clearly written and set out what support was needed and how it was to be carried out. People were very happy with the quality of the service given and in particular praised the care workers for their professionalism and commitment.

People felt confident that if they had any concerns they could speak to someone in the agency office and it would be sorted out to their satisfaction. From a satisfaction survey 86% of people using the service said they would recommend the service.