About the service:

¿ Consultancy Care Limited is a home care service. At the time of the inspection the service was supporting 13 people in their own homes.

People's experience of using this service:

¿ We received positive feedback about the service and the care people received. The service met the characteristics of good in all areas.

¿ People received safe care. Risks associated with their health and home environment were assessed and mitigated.

¿ People were supported by skilled staff with the right training and ongoing support.

¿ People were treated with dignity and respect.

¿ People received personalised care. The provider made adjustments to care arrangements to meet people’s diverse needs.

¿ There were effective management systems in place to monitor the quality and safety of the service. The registered manager promoted and open and transparent culture within the service.

Rating at last inspection:

¿ The rating at the last inspection on 1 September 2016 was good in all areas.

Why we inspected:

¿ This was a planned, comprehensive inspection of the service.

Follow up

¿ We did not identify any concerns at this inspection. We will therefore re-inspect this service within the published timeframe for services rated good. We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on the 4 July 2016 and was announced.

Consultant Care Limited is a small domiciliary care agency. Care and support is provided to people in their own home to promote their independence and well-being. At the time of our inspection the service was supporting 12 people .

The service had 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.

People told us that they felt safe with staff and would be confident to raise any concerns they had. The provider’s recruitment procedures were robust and medicines were managed safely. There were sufficient staff to provide safe, effective care at the times agreed by the people who were using the service.

There were procedures in place to manage risks to people and staff. Staff were aware of how to deal with emergency situations and knew how to keep people safe by reporting concerns promptly through processes that they understood well.

Staff received an induction and spent time working with experienced members of staff before working alone with people. The induction process was under review by the manager to correspond with the 15 standards that health and social care workers need to complete during their induction period. Staff were supported to receive the training and development they needed to care for and support people’s individual needs.

People and their families were complementary of the services provided. The comments we received demonstrated that people felt valued and listened to. People were treated with kindness and respect whilst their independence was promoted within their homes and the community.

People received care and support from familiar and regular staff and would recommend the service to other people. Two people told us that staff timekeeping could improve.

People’s needs were reviewed regularly and their care and support plans promoted person-centred care. Up to date information was communicated to staff to ensure they could provide the appropriate care and support for each individual. Staff knew how to contact healthcare professionals in a timely manner if there were concerns about a person’s wellbeing.

The provider had a system to regularly assess and monitor the quality of service that people received and identified areas for improvement.

An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with one person who uses the service and the relatives of two people who use the service. We spoke with the registered manager, a representative of the provider and three staff. We also reviewed records which included two care plans, daily care records, staff training records and other records relating to the management of the service.

Below is a summary of what we found. The summary describes what people and the staff told us, what we observed and the records we looked at.

Is the service safe?

People told us they would approach the agency or care staff if they were worried about their safety or worried about the services provided and felt they would be listened to.

People’s care plans detailed how the person wanted their needs to be met. Risk assessments identified risks associated with personal and specific care and support needs, and recorded guidance for staff to minimise those risks.

Staff knew how to report any concerns they had about the care and welfare of people and to protect people from abuse. Staff we spoke with confirmed they were given enough time on each call to meet the person's needs to a good standard. They felt they were provided with training that enabled them to do their job safely and effectively.

Is the service effective?

People’s preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. People we spoke with told us staff always turned up when they should and stayed the correct length of time. Comments from people we spoke with included: “I look forward to them coming and they stay the proper time”. A relative of a person who uses the service said: “The same staff are used, we know them all now and mum feels safe”.

Is the service caring?

People we spoke with felt the staff always respected their privacy and dignity. One person said: “They are very kind and do everything with a smile”.

People experienced care and support that was planned and delivered in a way that was intended to ensure people’s safety and welfare. People were complimentary about the care staff and felt they had the skills needed when providing care and support.

Is the service responsive?

The people we spoke with knew what to do and who to talk to if they had any concerns. All felt any concerns would be listened to and acted upon. One comment from a relative of a person who uses the services was: "The complaint procedure to me is no more than a phone call to the manager who is very responsive”.

Is the service well-led

The provider had a system to regularly assess and monitor the quality of service that people received. People who use the service, their representatives and staff were asked for their views about their care and support and they were acted on. Comments from people about the service included: “We are very happy with the services provided”.

At our last inspection on 14 August 2013 we found the provider was failing to operate effective recruitment procedures. We found the service had not carried out all requirements specified in Schedule 3 of the regulations. As a result we took enforcement action and issued the provider with a warning notice that required them to take action in order to become compliant with the regulations. The purpose of this inspection was to check that the provider had made improvements to their recruitment process and that information required by regulation were now on file.

At this visit we found the provider had reviewed the way it recruited staff. We found that the service had all information required by the regulations on file. The staff had completed new application forms and provided a full employment history. Any gaps in employment had been thoroughly investigated and the reason for the gap in employment had been explained in writing. The service had satisfied itself that staff were of good character and had the necessary qualifications, skills and experience to provide care to children and vulnerable adults.

At the time of this inspection Consultancy Care Limited provided care to two people living in their own homes and employed three care workers. We did not speak to people using the service as part of this follow up inspection.

We were following up areas of previous non-compliance identified at inspections carried out on 11 January 2013 and 15 May 2013. We had found the provider had not ensured that all information specified in Schedule 3 of the regulations, in respect of people employed to provide personal care to people in their own homes.

At this inspection we found the registered person had continued in not operating effective recruitment procedures.

At the time of this inspection Consultancy Care Limited were providing care to two people living in their own homes. Because of the small client group, and to preserve their anonymity, we have not used direct quotes from people in this report. We spoke with one person who uses the service and a relative and care manager of the second person. We also spoke with two of the three care workers employed by the service to provide personal care.

People experienced care and support that met their needs and was delivered in the way they preferred. People told us staff respected the privacy of the people who use the service and acted in line with their wishes.

Since our last inspection the provider had put appropriate arrangements in place to protect people against the risks associated with the unsafe use and management of medicines. Arrangements had been made for staff to receive training appropriate to their role and the manager was developing an in depth staff induction programme.

Improvements had been made to the staff recruitment documentation but the provider had not made sure all required information and documents were available for all staff employed.

The provider had implemented a system to assess and monitor the quality and safety of the service provided. People confirmed the manager asked for their views on a regular basis. They felt the manager was open to suggestions and were confident action would be taken promptly if they raised any concerns.

The registered manager is also responsible for the service as the nominated individual for the provider organisation. In this report when we use the term 'manager', we are referring to the registered manager/nominated individual for the organisation.

When we inspected the service they were providing personal care to five people in their own homes. We were not able to speak directly with the people using the service but we were able to speak with the relatives of four people and the social worker of the fifth person.

Relatives told us the staff respected the privacy and dignity of the person using the service, they told us staff were meeting people's needs and delivering care in the way they preferred. One person commented "the staff are all very friendly and happy. Nothing is too much trouble".

Relatives told us the service and staff were flexible and always willing to listen and change anything if asked. All relatives felt confident that the manager would take any comments or concerns seriously and would act swiftly to deal with any issues raised.

We found the service respected people's privacy and dignity and assessed, planned and delivered care that met people's needs. However, systems were not in place to protect the health, safety and welfare of people using the service in relation to the management of medicines, staff recruitment, staff training, the assessing and monitoring of the quality of service provision and records.