We carried out an inspection of Closer than Close Homecare Limited on 21 December 2016. This was an announced inspection where we gave the provider notice because we needed to ensure someone would be available to speak with us.

Closer than Close is a domiciliary care service providing personal care to people in their own home. At the time of our inspection, there were 17 people who received personal care from the agency.

The service had a registered manager in place. 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.

When a new recruit joined they spent two days shadowing a more experienced staff member before they started lone working. The service had introduced the care certificate and new staff were completing this. There had been some additional training within the past year for existing staff such as medication and dementia training but training was limited and relied on staff having training from previous employment.

Staff in the main enjoyed working at the service, but told us that there was currently a shortage of staff, which meant they felt pressured to cover visits. Safe recruitment process were followed.

People receiving a service from Closer than Close told us they felt safe. They said they had not had any missed calls, and when care workers were going to be late they usually received a message.

Staff received rotas each week and were notified of any changes. The service used an electronic call monitoring system where staff used a phone to notify the system of their arrival and departure. This provided some assurance that calls would not be missed. Travelling time was allocated between calls.

People were protected from abuse and avoidable harm. Staff understood how to keep people safe from abuse and how to raise concerns. Risks to people had been assessed and reviewed regularly to ensure people's individual needs were being met safely.

Medicines were recorded when the care workers were involved in administering them.

People received care from same regular care workers, and the registered manager tried to achieve this where possible.

.

On the day of our inspection, there were 19 people who used the service. We spoke with three people who used the service and one relative of a person who used the service. We visited one person in their home and spoke with four members of staff. We looked at three people's care records.

One relative of a person who used the service told us, "The care that we have been provided with has been beautiful."

We found that manual handling risk assessments had not been completed when these were required. This did not ensure the safety and welfare of the person who used the service.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Staff that we spoke with said that they felt supported by the service. One member of staff told us, "I am very happy. We're supported by our manager. If there's anything I need to know or additional training first person I speak to is the manager." Documents showed that staff were provided with regular training. Monthly online training was provided and we saw evidence that staff were supported to obtain additional qualifications relevant to their role.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

The complaints policy was brought to the attention of the people who used the service in an accessible format.

Following our visit we contacted four people who use the service by phone. We spoke with two relatives of people using the service.

Everyone we spoke with said that they were very satisfied with the care provided by the agency. They told us that their care workers were reliable, and provided all the care and support that they needed. One person told us, “I am very happy with the service. The staff are lovely, polite, courteous, helpful and well trained. Another person told us, I have no problem at all. They are caring, helpful and very accommodating.”

The people we spoke with told us that they were confident that the care workers had the training and support to be able to meet their needs. They said that they regularly saw the manager and found her very good. One person told us, “The communication with the manager and staff is very good.”

This service supports a small number of people with personal care in their own homes. We spoke with four people, one person's relative and the manager, who is also the provider. We also spoke with an office staff member and three care staff and looked at three people's care records. Other records viewed included staff records, policies and procedures and complaints records.

During our inspection and during analysis of our inspection findings we considered the questions we always ask, is the service safe, effective, caring, responsive and well led?

This is a summary of what we found;

Is the service safe?

We saw that risk assessments had been completed so that risks associated with people’s care and support could be minimised.

People were protected from abuse because the provider carried out proper safeguarding checks on new staff before they started working with people.

There were policies and procedures in place to protect people against mistakes with their medication, and staff had received medication training.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that care workers were provided with up to date information about how people's needs were to be met.

Is the service caring?

People told us that the care workers and office staff listened to them and one person said, "I couldn’t wish for more." Another person said, "They (the staff) are always kind."

People using the service completed satisfaction questionnaires. Where shortfalls or concerns were raised these were addressed.

Is the service responsive?

We were told that people got support when and how they wanted it. One person told us that the service was, “Flexible and makes changes to suit me.”

People also told us that they knew how to make a complaint if they were unhappy. One person said, "I have no complaints." Another person said, "I've been told how to complain, but don't need to. Any little niggles are seen to very quickly"

Is the service well-led?

The service had quality assurance systems in place and records showed that they identified shortfalls and acted to address them with the expectation that the quality of the service would continue to improve.

People told us that they were happy with the service and that their needs were met. One person said, “I’ve found the right agency, with the right person running it.” Another person said, "The service is excellent."