This inspection was announced and took place over a number of days and included 25, 26 July and 11, 18 August 2016.

Doris Jones Limited is a care agency that is registered to provide personal care to people within their own homes. The service is based in Leigh on Sea in Essex and covers the surrounding areas. The agency offers a range of support and rehabilitation services.

The service has 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.

The service was exceptional in their responsive approach to providing care to people. People were involved in their care provision and actively encouraged to feed into the service they received. The registered manager and staff were committed to a strong person centred culture and offered a ‘bespoke’ service. The service found ways to empower people to be involved in development and day to day running of the service. People lived full lives and the service always found ways to support people with their favourite pastimes or other things, like their favourite meals. Healthcare professionals spoke highly of the support provided by the service and how they worked with them to ensure people received a personalised service.

Kindness, respect, compassion and dignity were key principles on which the service was built and values that were reflected in the day-to-day practice of the service. People said they had been treated with dignity and respect and that staff provided their care in a kind and caring manner. Assessments had been carried out and care plans had been clearly developed around each individual’s needs and preferences. People were supported by staff to maintain good healthcare and where needed they would assist them to gain access or contact a range of healthcare providers.

There was strong emphasis on continual improvement and best practice which benefited people and staff. There were robust systems to assure quality and identify any potential improvements to the service. This meant people benefited from a constantly improving service that they were at the heart of. The service had an effective quality assurance system and had regular contact with people who used the service. People felt listened to and that their views and opinions had been sought. The quality assurance system was effective and improvements had been made as a result of learning from people’s views and opinions.

The registered manager promoted strong values and a person centred culture. Staff were proud to work for the service and were supported in understanding the values of the agency.

Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe. These had been regularly reviewed to ensure both staff and people who received a service were kept safe. Systems were in place to assist people with the management of their medication and help ensure people received their medication as prescribed and they received the support they needed.

There were safe and robust recruitment procedures to help ensure that people received their support from staff of suitable character. Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. There were sufficient staff available, with the right competencies, skills and experience to help meet the needs of the people who used the service. Staff told us that they felt well supported to carry out their work and had received regular supervision and training.

People knew who to raise complaints or concerns t

When we visited the provider we found that people had received an assessment of their support needs prior to receiving care and treatment. Care plans were written in a personalised way and planned and developed with them and/or their relatives. They contained details of their preferences in relation to the way their care was provided and were reviewed regularly.

One person we spoke with said, "The carers are very good and go that extra mile. They all have a nice way about them and encourage my independence and don't rush me at all."

People were protected against the risks of a health care related infection because staff had been trained appropriately and wore personal protective equipment to reduce the risk of cross contamination. Staff had been trained in food hygiene, infection control and hand washing techniques.

Staff were supported with relevant training, supervision and appraisal. New staff received induction training and their competency was checked before providing care to people in their own homes. The provider undertook 'spot checks' regularly to ensure that care was of a consistent standard. Annual appraisals took place for all staff.

The provider had an effective system to manage complaints. Records of complaints that we viewed reflected that they had been investigated and handled in line with their policy. Where areas for improvement had been identified these were cascaded to staff for future learning.