ClarkeCare is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to adults. At the time of this announced inspection of 22 May 2018 the agency provided 300 hours of personal care a week to people in the Bury St Edmunds area. This supported approximately 56 people. We gave the service 24 hours’ notice of our inspection to make sure that someone was available.

At our last inspection of 4 and 8 September 2015, the service was rated Outstanding overall. We found the evidence continued to support the rating of Outstanding overall and improvements had been made in the key question for Responsive. Responsive had become Outstanding. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had built on their previous success and sustained the outstanding model of care and support provided to people using their service. The management team and staff continued to find ways to improve the service and remained driven by their passion for caring for people, including those with dementia. The vision and the values of the service remained embedded.

Staff had an excellent understanding of people's needs and were imaginative in the way they provided person centred care which put people at the heart of the service. They continued to find creative ways of supporting people to have an exceptional quality of life and remain in their own home.

The service provided to people was safe. Where people required support with their medicines, this was done safely. There were systems in place which were intended to minimise the risks to people, including from abuse and in their daily lives. There were enough care workers to cover people’s planned care visits and for people to have consistent staff that they knew. Recruitment of care workers was done carefully and safely. There were infection control procedures and equipment in place to guide care workers in how to minimise the risks of cross infection.

The service continued to provide an effective service. People were supported by care workers who were well trained and supported to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the ethos, policies and systems in the service supported this practice. Where people required support with their dietary needs, systems were in place to support them. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

The service continued to provide extremely caring support to people. Feedback from all sources was consistently that people received kind, respectful and compassionate care. People had meaningful and positive relationships with the care workers and the registered manager. People’s dignity, privacy and independence were respected and promoted at all times. People’s views were sought, listened to and valued continuously.

The service provided was very responsive. People received care and support which was assessed, planned and delivered to meet their individual needs. Services were tailored to meet the needs of individual people and were delivered in a way to ensure flexibility, choice and continuity of care. People gave numerous examples of how flexible the service was to their changing needs. There were effective, caring systems in place to support and care for people at the end of their lives, where required. Staff had the skills to support people at the end of their lives and had received appropriate training to do so. A complaints procedure was in place and feedback was acted upon and used to improve the service to people.

Staff spoke consistently about the service being a good place to work. The registered provider had worked in partnership with other organisation

This inspection was announced and took place on 4 and 8 September 2015.

Clarke Care Limited (Suffolk) provides personal care and support for people aged 18 upwards living in their own homes. This includes supporting people following an illness or operation to get back to their usual routines. The service also supports people living with life changing conditions including dementia, multiple sclerosis and Huntington’s disease, as well as providing end of life care. At the time of our inspection there were 25 people who received a service from the agency.

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.

People told us they were introduced to the care workers so they knew would be supporting them. They felt safe and trusted the care workers who came into their home. Care workers knew how to safeguard the people who used the service from the potential risk of abuse. They demonstrated a good understanding of how to safeguard adults at risk of harm and knew how and who to report any concerns to.

The safety of people who used the service was taken very seriously and the registered manager and staff were well aware of their responsibility to protect people’s health and wellbeing. There were processes in place to ensure people’s safety, including risk assessments. These identified how the risks to people were minimised but also ensured people’s rights to choice and freedom.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

People told us that they were supported by a consistent team of very skilled care workers who they had developed good relationships with. People and relatives valued the relationship they had with the service’s management team and care workers. There were systems in place to ensure that people’s rights to respect, privacy and dignity were promoted and respected.

There were sufficient numbers of care workers to provide a caring flexible service. Care workers were trained and supported to meet people’s individual needs.

Where people required assistance with their dietary needs this was planned for and reviewed to ensure it was appropriate and safe. Where care workers had identified concerns in people’s wellbeing appropriate action was taken to contact other health and social care professionals to support people’s wellbeing.

People or their representatives, where appropriate, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information about how they communicated and their ability to make decisions. The service was flexible and responded positively to people’s requests about their care and how it should be provided.

The service provided support to some who only had a short time to live. Care workers focussed on working with the person to ensure comfort and choice. People told us the service was innovative, considerate and compassionate in these circumstances. The care also took account of the needs of those the person lived with, their family and friends.

People who used and worked for the service felt able to express their views and opinions to influence service delivery. The service was committed to person centred care and ensured that people using the service underpinned everything that they did.

There was good understanding of the importance of an effective quality assurance system. The registered manager was committed to continuous improvement and gaining feedback from people, whether positive or negative, which they used as an opportunity for improvement. A complaints procedure was in place. Although no complaints had been received the service encouraged people’s comments and used them to continually improve.

There was an open and empowering ethos in the service. The leadership was clear about their expectations relating to how the service should be provided and led by example. Care workers were very highly motivated, felt valued and proud to be working for of the service. They understood their roles and responsibilities in providing safe and high quality care to the people who used the service. They shared the service’s values in putting the person at the centre of their work care, as well as supporting family members.