This inspection took place on 20 February 2018 and was announced. We gave the registered manager notice of our intention to visit because we wanted to make sure someone would be at the office who could answer our questions during the inspection.

This service is a domiciliary care agency. It provides personal care to people living in their own homes and flats. It provides a service to older people and younger adults. At the time of our inspection, 44 people received personal care.

At our last inspection on 15 September 2016, we rated the service as Requires Improvement overall and in three of the key questions. These were in effective, caring and well led. At this inspection, we found improvements had been made since our last inspection and the rating has now changed to Good.

There was a registered manager working at the home at the time of our inspection. 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 they felt safe while receiving care and support. Staff understood their responsibility to report abuse and knew who they should report this to. People had risks associated with their care assessed and staff understood how to manage these to keep people safe. A core of regular staff who people knew supported them and there were sufficient staff employed to care for people.

Where people needed assistance with their medicines these were administered by staff who had undertaken the providers training. Staff followed guidelines to reduce the risk of cross infection and had access to personal protective equipment as required.

Systems in place to ensure staff were suitable to work with people in their own homes were robust to ensure checks had taken place and to make sure people were safe. The registered manager knew what action to take in the event of unsuitable staff gaining employment.

People had their needs assessed and information about their care and support was available for staff. The provider had an electronic care plan system which staff were able to access to obtain current information about people. The electronic system was used by staff to book in and out of their calls which enabled office based staff to monitor the calls to ensure calls where undertaken as scheduled.

People believed the staff caring for them to be trained and able to support them. Staff had received regular training including induction to meet their needs. Staff felt supported by the management.

People confirmed staff sought their consent prior to receiving personal care. People and their relatives told us staff were kind and caring. People confirmed staff ensured their privacy and dignity was up held while providing care.

Where needed staff had assisted people with healthcare appointments and staff knew what they needed to do in the event of finding a person unwell.

People were confident they could raise concerns about their care and believed they would be listened to. People spoke highly of the management and had confidence in them.

Further information is in the detailed findings below.

This inspection took place on 15 September 2016 and was announced. This was the first inspection at this location since the provider had moved to a new address.

Temple Mead Care Ltd provides personal care and support to people living in their own home. At the time of our inspection there were approximately 70 people receiving a service.

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. 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.

There were systems in place to monitor the quality of the service but the systems did not always ensure that people’s preferences were met.

People were kept safe from harm because staff were knowledgeable about the types and signs of abuse and the actions to be taken if abuse was suspected. Risks associated with people’s care had been assessed and plans put in place to manage them. Recruitment processes helped to ensure that only suitable staff were employed to support people in their own homes.

There were sufficient numbers of staff available to provide care however staff were not always available in the correct place to ensure that people received care and support at the times agreed and that met people’s preferences.

Most people were able to take their own medicines however staff were able to provide support if needed.

People were cared for by staff that were supported to carry out their roles because they had received training and on going support through on the job supervision and staff meetings.

People were supported to have food and drink that met that needs.

People had developed supportive and caring relationships with the staff that supported them to remain independent and make day to day choices about their lives.

People were supported to have their human rights upheld because they were able to consent and refuse care and support and were treated as individuals.

People were able to raise concerns but did not feel that they were always listened to.