Civicare East Limited is a domiciliary care agency that provides care and support to people within their own homes.

At the last inspection the service was rated good. At this inspection the overall rating remains good.

People felt safe using the service although some people expressed concerns regarding not being informed of changes to staff and not being introduced to new staff who had not visited them before.

Risks were identified and information on risks to people was shared with staff. However, recording information on risks and guidance on how to manage them in people’s care plans required improvement.

All staff had completed safeguarding training and there were systems and processes in place to respond to incidents or allegations of abuse.

There were sufficient staff employed who had been safely recruited. Staff had time to spend with people and were not rushed. There were no reported incidents of missed visits and care staff were generally punctual. However, when staff were going to be late this was not always well communicated to people.

Staff had received training in how to administer medicines. However, improvements were required to ensure more robust assessment and monitoring of staff competence to safely manage people's medicines.

We made a recommendation that protocols for ‘as needed’ medicines be introduced to ensure a more robust medicine management system.

Accidents and incidents were recorded and analysed. Lessons were learned and action taken to improve the quality and safety of the service for people.

Staff received an induction, training, regular supervisions and spot checks and appraisals. This ensured staff had the necessary knowledge and skills to be competent in their role.

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. People's consent was sought before care and support was provided.

People were supported to have enough to eat and drink and received support to access healthcare professionals when their health needs changed.

Staff were kind and caring and often went the extra mile. People’s preferences were known and respected. People were treated with dignity and felt listened to. People received care and support how they liked it and their independence was encouraged.

People received care that was tailored to meet their individual needs. People’s care was regularly reviewed and any feedback from people or their relatives was acted upon. People were supported to access the community and engage in activities they enjoyed.

There were systems in place to manage complaints and people knew how to make a complaint. Feedback from staff, people and relatives was sought and acted upon to improve the service

Quality assurance systems were in place to monitor the safety and effectiveness of the service. There was robust oversight of the service and clear lines of accountability at staff, management and provider level.

Further information is in the detailed findings below

People who used the services of Abacus Care told us that they were happy with their care and support. One person said: "We have two regular carers. They are very sensitive and reassuring. They respect our home and our funny ways. They make us feel good.”

People were involved in their care and support arrangements and treated with dignity and respect. People and their relatives had been asked their views, their care arrangements had been reviewed and records updated. The manager and staff had the necessary knowledge and experience of safeguarding vulnerable adults from abuse.

A system was in place for the assessment and monitoring of the quality of the service. Whilst people who used the service could be assured that they received a safe, well maintained and managed service, improvements were needed in the recording of information in the staff personnel files that we viewed.

Civicare East Ltd provides personal care services to people in their own home. At the time of our visit the service was supporting 45 people.

Civicare East Ltd has 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.

There were sufficient staff available to meet people needs and people told us that they liked having consistent carers. Staff worked in geographical areas and calls were at least an hour in length enabling staff to spend time with people and meet their needs.

Recruitment procedures were thorough offering protection to people. Staff were clear about safeguarding procedures and the actions they should take to protect people where a concern was identified.

Medicines were safely managed but the agency was reviewing its practice and was planning changes to further strengthen the arrangements in place.

Risks to people were well managed through a risk assessment process which looked at both environmental and individual risks.

Training was well organised and staff undertook a combination of on line and face to face training. This ensured that they had the skills and knowledge to meet people’s needs. Staff were aware of issues with regard to consent and observed the key principles in their day to day work , checking with people that they were happy for them to undertake care tasks before they proceeded.

Support was available to support people to maintain a balanced diet and to access health services.

People were happy with the care they received and had good relationships with staff. They told us that their privacy and dignity was promoted.

Care records were informative and provided staff with detailed guidance enabling them to care for people in a person centred way. Staff knew the needs of individuals they supported and people told us that they were involved in how their care was delivered. People told us that their preferences were respected.

There was a system in place to deal with complaints and people were encouraged to provide feedback.

Leadership was visible and staff felt supported by the manager and office staff. Feedback was sought by the manager in a number of ways including surveying people who used the service. Feedback was used to drive improvement and improve outcomes for people using the service.