We undertook an announced inspection on 7 June 2017.

We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their homes; we needed to be sure that someone would be available at the office. Dove care agency is a domiciliary care agency who provide personal care and support for people living in the community with a range of needs. Some people were provided with 24 hour care others had arranged visits to meet their needs. At the time of our inspection 79 people received support with personal care.

At the last inspection in August 2014, the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 continued to receive care in ways which helped them to remain as safe as possible. Staff understood the risks to people’s safety and were able to respond to peoples’ needs. Staff we spoke with recognised the different types of abuse. There were systems in place to guide staff in reporting any concerns. There were enough staff available to ensure people’s needs were met. People were supported to receive their medicines by trained staff who knew the risks associated with them.

The care people received continued to be effective. Staff received training which matched the needs of people they supported. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff ensured people agreed to the support offered before assisting them. People were supported to eat and drink well when part of their identified needs. They were supported to stay well and had access to health care services.

People had built caring relationships with staff and were encouraged to make their own choices and maintain their independence. People were treated with dignity and staff were respectful to people’s wishes. People and their relatives said staff and management team were caring and kind.

People and their relatives’ views and suggestions were listened to. People’s care plans reflected their preferences and people told us the service adapted to meet their needs. Systems were in place to promote and manage complaints.

Staff were involved in meetings, to share their views and concerns about the quality of the service. People and staff said the management team were accessible and supportive to them.

People, their relatives and staff were encouraged to make any suggestions to improve the care provided and develop the service further. The registered manager worked with people, their relatives and other organisations in an open way so people would enjoy the best well-being possible. Regular checks were in place to assess and monitor the quality of the service and action taken to drive through improvements for the benefit of people who were supported by the service.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. The inspection was announced.

The service provides personal care and support to adults with long-term illness, physical and learning disability or mental health needs, in their own homes, providing a live-in or daily care service. Eighty-five people were receiving the service at the time of our inspection. The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

At our previous inspection in December 2013, we found there was a breach in meeting the legal requirements for care and welfare. We found people’s care plans did not always provide staff with sufficient information about the care and support people required to meet their health care needs and maintain their safety. The provider sent us a report explaining the actions they would take to improve.

During this inspection we found the necessary improvements had been made to meet the requirements for care and welfare. The provider had obtained advice from clinical health professionals, who were already involved in people’s care. The health professionals had written detailed guidance for care staff to refer to when they undertook delegated health care tasks. We saw the guidance was included in the care plans appropriately.

People told us they felt safe with staff and that staff supported them according to their needs. Care staff we spoke with understood the importance of protecting people from harm and enabling and promoting their independence. Care staff told us they were supported to care for people safely because the provider made sure that appropriate care plans, training and equipment were provided. Staff were confident in their practice and told us they enjoyed their work.

People’s care plans included risk assessments and actions for staff to take which minimised risks to their health and well-being. Care plans included how staff should support people with their personal hygiene and medicines and the actions staff should take to minimise the risks of harm or of infection.

People confirmed that staff supported and cared for them how and when they preferred. People told us they took comfort in knowing that staff recognised signs of ill health and made sure that other health professionals were involved in their care appropriately.

All the people we spoke with told us staff were kind and thoughtful and took time to get to know them.  People told us staff treated them with respect and helped them to maintain their dignity. We found the provider assessed staff’s attitudes and behaviours during their recruitment and probationary period to make sure they were suitable to deliver one to one personal care. Staff were trained and supported by senior staff, who were designated champions for dignity and dementia, in accordance with the Social Care Institute of Excellence (SCIE) guidance.

There were robust systems in place to monitor and improve the quality of the service.  The provider conducted regular surveys and care reviews to make sure people were able to express their views. Senior staff checked that people received the service they needed by observing staff in practice. Senior staff checked daily records of care, medicines administration records and observed how staff prevented and controlled the risks of infection.

People who used the service knew the provider’s complaints policy. Records showed that the manager took complaints seriously and responded to them effectively.

Everyone we spoke with was happy with their care, the staff and the quality of the service. The manager conducted regular quality monitoring one to one conversations and surveys to make sure they delivered a quality service. People and staff had confidence in the manager.

We carried out a routine inspection at Dove Home Care Agency on 15 January 2014. We looked how people were cared for at each stage of their care and treatment. We talked to people and relatives who used the service prior to the inspection and we talked to staff.

Our inspection included a visit to the agency's office. This was an announced inspection. On the day of our visit we were told Dove Care Agency provided support to 90 people and employed 68 care workers.

We looked how staff were recruited to the service and how they were supported to provide care to people in their homes. We looked at staff training and we looked how the service measured the quality and standards of care provided.

During our inspection we looked at four care records and four staff files. We spoke with the care manager, office manager and three care workers.

Prior to visiting the office we spoke with fourteen people who used the service to find

out about their experiences of using the agency. They all told us they were happy with the service they were receiving. One person stated, “Having experienced other agencies, they are absolutely first class"

Care plans and risk assessments were in place but did not always reflect the care required to meet people’s needs.

We saw the service followed a robust recruitment process. We saw staff training was not always well attended.

The service conducted checks and audits to monitor the standards of care being delivered.

We found the provider to be compliant in the areas of involvement and information, personalised care, safeguarding and safety, staffing and quality management. We spoke to staff, observed policies and processes, reviewed ten sets of notes, visited one person and contacted seven people using the service or their families to gain further insight of the care provided.

People using the service were very happy with the care provided. Most of the people we talked to had used the provider for a number of years and felt the service was "good all round". One person new to the service said they were "much better than than she had hoped for". Another told us "all the staff fit in extremely well".

There are processes in place to recruit staff and support their training. All the staff we spoke to enjoyed their job and felt the provider supported them.

We saw evidence of quality management processes to audit the quality of care and deal with incidents and complaints.

We saw evidence that people who use the service were consulted about their care and felt the care was of a high standard.