The inspection took place on the 19, 20 and 25 of January 2017 and was announced the first day. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be there to facilitate the inspection.

At the last inspection the service was meeting all of the legal requirements.

Disablement Association of Barking and Dagenham provided a number of services to support to adults and children in the community which included transport services, support with independent living and personal care.

At the time of the inspection 35 people at the service were receiving personal care.

The service required 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 service was in the process of recruiting a registered manager. The service was supported by a personal support service lead (PSSL) who managed the day to day running of the service.

People at the service were supported by staff who kept them safe as they had been trained in safeguarding adults and children and knew how to report abuse to their manager. Staff also explained they would whistleblow to external agencies if they thought someone they supported was at risk of abuse.

People told us they received their medicines on time and that staff supported them fully where it was a requirement of the care package. Staff were trained in the safe management of medicines and explained how they administered or prompted people with their medicines.

Staff stated they always risk assessed people’s homes when they arrived. Risk assessments surrounding people’s environment and any equipment used were produced to protect people from any harm.

Safe recruitment was carried out. Records showed that staff’s previous employment history was checked and suitability to work was confirmed with a criminal records check.

In the event of an emergency staff explained how they would respond to keep people safe, by seeking further advice or calling the emergency services. The service had an out of hours telephone line for staff and people to use.

Staff received regular training, supervision and an annual appraisal. Staff felt well supported when they first joined the service and that they could approach their colleagues for advice. People were listened to at the service and encouraged to make choices. Staff emphasised they were there to encourage people’s own decision making, seek their consent and give care according to people’s wishes.

People were supported to eat healthily and people saw appropriate health professionals to maintain their health and wellbeing.

People received support from staff who were kind and compassionate. Staff took the time to find out people’s interests so they could actively engage in conversation and get to know people.

People’s care plans were personalised and reviewed regularly. Care plans detailed how to support people with their daily choices and routines and support their goals. People took part in a number of activities of their choice and some of which were provided by the service to avoid isolation.

People and their relatives spoke positively about management at the service and felt they could contact them easily. Staff were happy with management and felt well supported to raise concerns they had about people or their work within the service.

The service had number of quality monitoring systems at the service which included spot checks to monitor staff and sending questionnaires to staff.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We spoke with eleven people who used the service. People told us that they were given sufficient time and were “not rushed” into make a decision about whether to sign up to the service.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. All the records we reviewed contained needs assessments that defined what was in people’s care plans.

Appropriate arrangements were in place in relation to the recording of medicine. There was a medication profile record for each person who was taking medication.

There were enough qualified, skilled and experienced staff to meet people’s needs. The staff we spoke with told us that they never felt pressure to work quicker and had enough time to do their jobs well. People described the service as “Really good” said they were “very satisfied” with the service.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We saw that customers were given a “your feedback” form that gave them the opportunity to give feeback about the service.

We spoke with some people using the service, who gave us positive feedback about the service. The feedback included, “they ask me how l wish things to be done” and “the carers are so polite”. People told us that their privacy and dignity was respected.

We saw that the management were aware of the care needs of people and of their preferences and daily routines. “Staff attend to my needs and they treat me very well”, an individual receiving care had told us.

People receiving care indicated that they were well treated and felt safe with the care staff. They commented positively on staff timekeeping, stating, “I am always told beforehand if there was any problem”. They commended care staff’s competency, commenting that “they talk to me in such a way that l feel at ease”.

We observed people who use the service were asked for their views about their care which were acted on.

People who use the service made positive comments regarding the care they received. One person said, “I have had no problems with the agency and if I have had, they sort them out straight away. I have regular carers and the majority of times they are arrive on time. If they are going to be late, they do let me know.” A relative spoken to said, “On the whole they are very good. To be fair if they are going to be late, they do ring.” Another relative said, “The quality of care is very good. The current carer is perfect and is very nice. They are always on time and they are never late.” A further relative said, “The communication is very good from the agency. If I ring the office the staff there are very accommodating and are very helpful.”

When asked whether they received a flexible, consistent and reliable personal care service. One person said, “I am very satisfied with the service.” Another person told us that “I have regular carers and the majority of times they arrive on time. If they are going to be late, they do let me know.” A relative spoken to said, “On the whole they are very good. To be fair if they are going to be late, they do ring.” Another relative said, “The quality of care is very good. The current carer is perfect and is very nice. They are always on time and they are never late.”

Further positive comments were received regarding the care provided by the agency by people using the service. Comments included;

“My carers are wonderful.”

“My loved one loves the carer. They go out laughing with them and they come back laughing. We have no complaints.”

“I am very happy with the services.”