We undertook an announced inspection of Complete Care Windsor on 19 December 2018. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. On the day of our inspection 80 people were being supported by the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.

We were greeted warmly by staff at the service. The atmosphere was open and friendly.

People told us they benefitted from caring relationships with the staff. There were sufficient staff to meet people’s needs and people received their care when they expected. Staffing levels and visit schedules were consistently maintained. The service had safe, robust recruitment processes.

People were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

Where risks to people had been identified risk assessments were in place and action had been taken to manage the risks. Staff were aware of people’s needs and followed guidance to keep them safe. People received their medicine as prescribed.

Staff had a good understanding of the Mental Capacity Act (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected.

People were treated as individuals by staff committed to respecting people’s individual preferences. The service’s diversity policy supported this culture. Care plans were person centred and people had been actively involved in developing their support plans.

People told us they were confident they would be listened to and action would be taken if they raised a concern. We saw a complaints policy and procedure was in place. The service had systems to assess the quality of the service provided. Learning was identified and action taken to make improvements which improved people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the registered manager. Staff supervision and meetings were scheduled as were annual appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.

People told us the service was friendly, responsive and well managed. People knew the managers and staff and spoke positively about them. The service sought people’s views and opinions and acted upon them.

Complete Care Windsor provides personal care throughout Windsor and Maidenhead to older adults, some of whom have dementia . The office is located in a commercial area of Windsor, with staff working from hubs throughout the local area. The service encourages adults to achieve maximum independence, health and wellbeing. Services may include supporting people to manage their personal care (washing, dressing, medicines administration), companionship and other daily tasks such as meal preparation, and support in the community.

At the time of the inspection, there was 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.

The location was last inspected under the 2010 Regulations on 3 July 2013, where the five outcomes we inspected were compliant. This is the first inspection of the location under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At the time of the inspection, 70 people used the service and there were 30 staff. People were able to receive care visits in the morning, at lunch time, at supper and in the evening. The service also operated 24 hours a day, seven days a week and people, relatives, staff and healthcare professionals could telephone the office anytime to receive support.

We found Complete Care Windsor used a comprehensive assessment and care planning process which ensured that people’s care was detailed and encompassing. Staff we communicated with were professional and caring and enjoyed working with people who used the service. People’s opinions of the care provided were consistently positive. There were sufficient staff to meet people’s needs at all times, and the service incorporated a robust method of determining correct staff deployment. People’s medicines were administered, stored and documented appropriately.

The service was effective in the care it provided to people. Staff received extensive induction, training, supervision and performance appraisal for their roles. The service had utilised Skills for Care’s ‘Care Certificate’ for new care workers and there was evidence that staff had successfully completed the many components. Staff received regular supervision with their managers and were able to set and achieve their own employment goals. Recruitment and selection of new staff members was robust and ensured safety for people who used the service. Consent was gained from people before care was commenced and people’s right to refuse care was respected.

We found staff were kind and generous. People’s comments mirrored our findings from the inspection. Staff told us they respected people’s privacy and dignity, and ensured that life in their homes was as close as possible to being independent. People had regular opportunities to provide feedback to the service and also have their say in how things operated.

The service was responsive to people’s needs. People had the ability to share their compliments, concerns and complaints in an open and transparent manner. Where feedback was provided by people or relatives, management would undertake necessary investigations, make changes to their care package and report back to the person who complained.

All of the people and staff we spoke with as part of the inspection commented that the service was well-led. They felt that the managers took time to listen and would take action to make improvements when needed. People felt that management were approachable and had a visible presence in the operation of the service. We found that the management conducted a range checks to assess the standard of care. This included satisfaction surveys where people consistently rated the service outstanding.

We spoke with nine people who use the service, and nine relatives of people who use the service. All were complimentary about the care provided. They told us the service listened when they wished for changes to be made. One person told us “I’ve used them for years. They are marvellous.”

We saw that care was provided in accordance with people’s agreed care plan. People had an initial assessment, and regular and responsive reviews to ensure care remained appropriate to the person’s needs. One relative told us “We’ve done unannounced checks ourselves, and we’ve been impressed with what we’ve seen. The care has been excellent from the start.”

We spoke with six care workers. They told us they had attended safeguarding training. They were able to explain what would alert them to potential safeguarding incidents, and understood the actions they should take to deal with these, in accordance with the provider's safeguarding policy.

We saw evidence care workers had regular supervision sessions and appraisals, and observed their training was up to date in accordance with the provider’s own policy. Care workers told us they were encouraged to gain health and social care qualifications.

We saw the provider carried out a survey with people who use the service and their relatives, and responded appropriately to complaints. They conducted suitable risk assessments and reviews to ensure people’s welfare and safety were maintained.

We spoke with two people who use the service regularly and a relative of a third person. They all told us they were involved in making decisions about the care and support they received. The relative told us, "They always treat my husband with respect, and ensure that he is not uncomfortable"

Assessments of people's needs included the domains of health and social care, including medical problems, social and cultural needs.

Staff training about managing medicines was done with a local pharmacist. We saw a training log which showed 22 out of 24 staff had participated in medication training within the last two years.

We observed the provider had detailed information in the service user guide in each person's home about how to make a complaint. The provider also had a written policy which explained the steps for managing concerns or complaints.