About the service:

Daisy Chain Home Support is a domiciliary care service that provides personal care to older people in their own homes within the Manningtree area. At the time of our inspection the service was supporting 23 people with personal care.

People’s experience of using this service:

People received care that was person centred, caring and responsive to their diverse needs. Staff ensured that people received care in a manner that they wanted. Staff demonstrated their commitment to ensuring people received appropriate standards of care and support. People and their relatives described warm and strong relationships they had built with staff and how they had exceeded their expectations.

People felt safe receiving care from the staff. Staff were deployed in suitable numbers, and they had time to spend with people and were not rushed. People received their medication by trained and competent staff. Staff were recruited safely, and incident and accidents were analysed for patterns and trends. Risks to people were assessed safely.

Staff had the correct skills to support people. They received regular training, support and supervision with their line manager. Staff also received an annual appraisal. People were supported to eat and drink in accordance with their needs. Decisions and consent to care and treatment was sought in line with the Mental Capacity Act 2005.

Everyone said staff were exceptionally kind and caring. Staff were able to describe how they ensured people's dignity was respected. People and their relatives said they were involved in their care plans.

The service was managed very well, the ethos and culture of the service was well implemented with the staff team that provided the care. Staff all spoke fondly about the registered manager and spoke about their roles with enthusiasm and pride. Audits were in place which were effective in highlighting any areas for improvement. Action plans were drawn up and shared with the staff team.

The registered manager engaged with people who used the service to ensure any areas where improvements were needed were being actioned. The registered manager was aware of their role with CQC and had notified us of all incidents as required.

Rating at last inspection:

Good (Report published 24 August 2016)

Why we inspected:

This was a planned comprehensive inspection based on the rating from the previous Inspection in line with our methodology.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

The inspection took place on 22 March 2016 and was announced. The service is registered to provide personal care and is a domiciliary service. There were twenty people receiving care at the time of the inspection.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 service was outstandingly well-led which was demonstrated by how the staff were supported and how well the service was organised to ensure people received high standards of care according to their assessed needs. People told us the service was great, while another said it could not better. Communication between the service and people were good. People told us they liked having the same carers and said they went the extra mile for you when needed. Another person said they could not praise the staff enough. They said the service provided the two qualities they were seeking which were it was trustworthy and reliable. The care plans were person-centred written to clearly identify the support required alongside what the person could do for themselves.

Staff had attended training designed to help them recognise abuse and know what actions to take to protect people as far as reasonably possible from actual or potential harm, or abuse. Staff had a very good understanding of their roles and responsibilities. People using the service were supported by a sufficient number of suitably experienced staff. The manager carried out appropriate recruitment checks before staff began work with the service. Staff had been recruited safely and had the skills and knowledge to provide care and support in ways that people preferred. As part of the assessment process to determine if the service could meet the individual’s needs, people were asked about their preferences and choices.

The service had a medicines policy, staff had received training and systems were in place to manage medicines and people were supported to take their prescribed medicines safely.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and in particular Best Interest Meetings.

Positive and caring relationships had been developed between people and staff. Staff responded to people’s needs in an understanding and empathic manner. People’s choices were respected as was their privacy and dignity. The care plans were written to take account of people’s needs and to promote and maintain independence. People were involved in the planning and reviewing of their care and support, as were family members with their permission.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles and had annual appraisals to discuss their performance and career development. Part of the supervision process was for the service to carry out spot checks of the care delivery.

Staff supported people with their health care needs including where required monitoring of people’s food and fluid intake. The service reviewed people’s care to ensure the service continued to meet their needs and they worked with other professionals to ensure needs were met as comprehensively as possible. The service arranged community activi