Clifton Care agency provides support and care for people in their own homes across the Clifton area of Bristol. At the time of this inspection there were nine people using the service

At our last inspection it was rated Good.

At this inspection it remained Good.

Why the service is rated good

People who used the service told us they felt safe. People told us they were looked after by staff that knew them well and gave them individual attention. Staff respected people’s privacy and dignity and their individual preferences.

Staff received training to support them with their role when they joined the service and on a continuous basis, to ensure they could meet people’s needs effectively.

People were supported to maintain their independence and maintain their life skills with necessary support required to help them retain their independence.

People received regular assessments of their needs and any identified risks. The service worked co-operatively with external agencies and people’s families.

People who used the service, families, staff and professionals who we had contact with spoke positively about the quality of care that the staff team provided. People

thought the service was well run and that their needs were met.

We carried out an inspection at Clifton Care . This helped us to answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service told us they felt safe and comfortable with staff. One person told us “I feel safe and comfortable with staff I have no concerns”.

The provider had written policies covering adult protection and whistle blowing. These made clear the vulnerability of people who used the service and the duty of staff to report any concerns they may have to a responsible authority for investigation.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw that the service had identified and managed risks in relation to the health and safety of people who used the service. The care plans we looked at contained detailed risk assessments. The risk assessments had detailed the actions required to help staff minimise or eliminate the risk.

Is the service effective?

We looked at two care plans in detail for people who used the service. We saw that an assessment of needs had been completed before they had started to use the service and information compiled during the assessment was used to develop their care plan. This meant the service had sufficient information to be confident that they could meet the person's individual needs.

All staff had received regular mandatory training and updates. Training courses covered all the required mandatory subjects. These included adult protection, mental capacity awareness, moving and handling, fire safety, first aid, food hygiene and health and safety. A member of staff told us, "We get good training which meets our needs"

Is the service caring?

People who used the service told us they were happy with the care and support provided by the agency and that they had been involved in assessments to decide if the service could meet their relative's needs. One relative told us, "They are quite flexible, caring and responsive. We get on so well with the manager. She is very caring.

Is the service responsive?

People told us that they were involved in regular reviews regarding their care and support. People said that they could raise any concerns they had with the manager and felt confident that the appropriate action would be taken quickly to improve the quality of care provided.

We saw that staff maintained daily records of the care they provided. Any appointments, for example, GP appointments and hospital appointments for the person were also recorded. Professional advice received as a result of the visit was recorded and the care plan updated where necessary.

Is the service well-led?

People who used the service were encouraged to give feedback about the services they received in the style they preferred, and relatives were enabled to express their ideas and opinions. The provider had carried out quality assurance surveys for people who used the service and their relatives. One relative told us “They regularly keep me informed and they are doing a really good job. It is a huge relief for me to know that my relative is being looked after very well”.

People who used the service said that they were well looked after. They told us that the staff always asked them how they would like things to be done, always respected their privacy and treated them with respect. They said staff talked to them about how they liked their support to be provided.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff spoke to us knowledgeably about their awareness of how to keep people safe from harm.

Staff told us about the training they had received so that they would be able to recognise abuse and how to report it.

People told us that staff were punctual and reliable. People's relatives told us that staff were always friendly and professional when they visited. One person said they were brilliant and always on time another said "they are very caring staff they go over and above what they are supposed to do ".

People we spoke with said their comments were listened to by staff. A relative said that they would speak to the manager and staff if they had any concerns about the service. “we have no complaints”.

People we spoke with told us they were happy with the care and support provided by the agency. People said they were assessed by the manager before they started receiving care and support. They said they had been involved with developing their care and support plan and staff had treated them kindly and politely. For example one person said “I know about my care plan, they went through it with me but I am not sure if I signed it. Staff treat me like an individual. Clifton care is very good indeed.

We saw that the provider had a policy on safeguarding people from abuse. However, some staff had not attended training to help ensure that people who used the service were protected from the risk of abuse.

We saw the provider had effective systems in place to regularly to monitor the quality of service that people received.

We found from speaking with staff and looking at training and supervision records that the provider had not ensured that people who used the service were cared for by staff with appropriate training and support

We undertook an inspection on the 30 April and called people who used the service and relatives on 5 May. The inspection was announced, which meant the provider knew we would be visiting. This is because we wanted to make sure the provider, or someone who could act on their behalf, would be available to support the inspection. When the service was last inspected in May 2014 there were no breaches of the legal requirements identified.

Clifton Care provides personal care and support to people in their homes in the Bristol area. At the time of our inspection the service was providing personal care and support to 12 people.

A registered manager was in post at the time of inspection. 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 felt safe when staff visited them and provided their care. A range of checks were carried out on staff to confirm they were suitable for the work. The recruitment process was thorough to ensure people were well protected.

There were sufficient staff available to meet people’s needs. Staff told us that staffing levels were sufficient and told us they had time to meet people’s needs. Staff understood how they should protect the rights of people who lacked capacity to make decisions as required by the Mental Capacity Act 2005.

Staff had got to know the people well and did what was expected when they visited. One person commented that the staff were knowledgeable and told us; ‘they’re experienced, caring and thoughtful people. Everything I ask of them, they know what to do.’ People told us that staff were caring and their privacy and dignity was respected and they had a positive relationship with the staff. One person commented ‘if I have to use the commode, they would ask if I would like them to leave the room. They’re polite and courteous.’

People were supported to see healthcare professionals when required and records showed that staff responded promptly to people’s changing needs. The service had appropriate systems that ensured referrals to healthcare professionals were made.

There were arrangements in place for obtaining people’s feedback about the service. People who had raised concerns felt they had been listened to and thought the manager was approachable. One person commented ‘there had been staff changes and I hadn’t been consulted. So I raised it and it has never happened again. Staff told us they felt supported and kept up to date with and developments.

People who used the service knew the registered manager and thought they were approachable. The registered manager communicated with people frequently to ensure the care provided met their needs.