This inspection was completed on 19 and 20 December 2016 and was announced. The provider was given 48 hours’ notice because the service provides a domiciliary care service; we needed to ensure we would be able to meet with people where they were receiving the service. At the time of the inspection, the service was supporting 86 people in their own homes.

There was a registered manager in post at the service; 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was last inspected in October 2013. There were no breaches of regulation at that time.

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment. People’s medicines were being managed safely. People told us they felt safe.

People were receiving effective care and support. Staff received training which was relevant to their role. The service was adhering to the principles of the Mental Capacity Act 2005 (MCA).Staff supervisions and appraisals were being completed. People were supported to access health professionals. People could choose what they liked to eat and drink.

Staff told us there was an open culture and the environment was an enjoyable place to work. Staff were extremely passionate about their job roles and felt integral to the process of providing effective care to people. There was positive feedback from relatives regarding the management.

The service was caring. We observed staff supporting people in a caring and patient way. Staff knew the people they supported well and were able to describe what they liked to do and how they liked to be supported. People were supported sensitively with an emphasis on promoting their rights to privacy, dignity, choice and independence. People were supported to undertake meaningful activities, which reflected their interests.

The service was responsive to people’s needs. Care and support plans were person centred to provide consistent, high quality care and support. Daily records and visit notes were detailed and contained sufficient information for staff to read and support people effectively.

The service was well led. Quality assurance checks and audits were occurring regularly and identified actions to improve the service. People, staff and relatives spoke positively about the registered manager.

We spoke to five people who use the service during the course of the review. The people we spoke with were positive about how the agency responded to their care needs and also told us that the agency had been quick to respond to changes in care needs.

When we asked people if they were involved in discussions about their care, we were told by people who use the service: “We were involved during the assessment process with a member of staff from Elite home care service.”

People who use the service were confident that their needs are met by this agency and they spoke positively about the care they receive. People said; “We are supported in the choices we make and the agency goes above and beyond to provide care.”

People who use the service told us; “We are happy with the carers and in some instances we are lucky enough to get the same one each time.” The provider also told us; “People with specialist needs often get the same carer each time and at the current time have been able to maintain this.”

People who use the service told us how they had been supported by the agency in order to avoid being socially isolated; One person told us, “I had been lost recently as many of my friends had died and I was so isolated but Elite has been a god send as I now have the support I need to go out and meet people and socialise”.

When we asked people about if they knew how to raise concerns or complaints about the agency, people we spoke to told us; “We have nothing to complain about and if we did we would be able to do so”. Another person told us, “I have no complaints and no concerns with Elite I am very happy with the care”.

There have been no complaints or concerns raised to us about the service.

People we spoke to were positive about the care they received from Elite home care agency.

People who use the service told us; “I have a copy of the complaints procedure, I have never used it as I’m happy with the service I receive.”.

People who use the service told us; “We are so appreciative of the service, we have been able to make friends with our carers and we can not express how much comfort this agency has brought. They have shown dedication and effort and they have been there for us in our time of need”.

People told us that overall they were supported by a regular team of care staff, calls were not missed and staff arrived on time. People told us " I am cared for by good staff, they are like family to me” and “I look forward to staff coming to help me, often they are the only people I see for days. It can be quite lonely sometimes and they brighten my day, as well as helping me”. Another person told us “If I have new staff coming to do my call then they always come with somebody that knows me first so they can introduce them to me”.

Clear information was in place about people's abilities to make decisions. Information had been recorded to show if people were able to give consent for the support and treatment affecting their health and care.

People were cared for by staff who had been through a robust recruitment process. On-going monitoring, training and supervision of staff took place.

Quality assurance checks had been completed to help continually improve the service. The team leader and senior care staff conducted regular spot checks on staff performance and the provider obtained feedback regularly. People who used the service told us they felt able to raise a complaint if they had one. We found that people and staff felt confident taking any suggestions or concerns to the provider. A relative of one person told us that, "I find the manager and staff approachable, they are caring, professional and kind and know my mother well”.