This inspection took place over a number of days and included 29 February and the 2, 3, and 7 March 2016.

Essex Care South East (ECL) provides a number of different services. This includes providing care and support within people’s homes and a reablement service for up to six weeks for people who have been discharged from hospital. The focus of their support is to rehabilitate people back to independence. They provide personal care and support to adults who live in their own homes in the geographical areas of Rochford, Rayleigh and Castle Point.

The service is also a ‘provider of last resorts (POLR).’ This is where Essex County Council are unable to find another contracted service to provide care and ECL will then assist with the care (short term) until another provider can be found.

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.

Staff had a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Where safeguarding concerns had been identified the service had made the appropriate referrals and was open and transparent. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

Systems were in place to assist people with the management of their medication and to help ensure people received their medication as prescribed. Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff told us that they felt well supported to carry out their work and had received regular support and training.

There were generally sufficient numbers of staff, with the right competencies, skills and experience available to help meet the needs of the people who used the service. Where there had been staff deployment problems, the manager had made changes and were in the process of recruiting more staff to ensure they have sufficient number when staff were on leave, sick or when the work as a POLR increased.

Where needed people were supported to eat and drink sufficient amounts to help meet their nutritional needs and staff knew who to speak with if they had any concerns around people’s nutrition. People were supported by staff to maintain good healthcare and were assisted to gain access to healthcare providers where possible.

People had agreed to their care and been asked how they would like this provided. 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 developed around each individual’s needs. People had also made ‘goals’ to achieve to assist them in regaining their independence.

The registered manager had a good understanding of Mental Capacity Act 2005 and who to approach if they had any concerns and the appropriate government body if people were not able to make decisions for themselves.

People knew who to raise complaints or concerns to. The service had a clear complaints procedure in place and people had been provided with this information as part of the assessment process. This included information on the process and also any timespan for response. We saw that complaints had been appropriately investigated and recorded.

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.

People receiving care were complimentary about the care staff and expressed that they were happy with their care and support. They did not raise any concerns about the care they received and their comments included, “Well they are all very nice and caring and nothing is too much trouble,” “They are very very kind and very helpful,” “They are very good, I cannot fault them. They are reliable and on time” and “They are usually different ladies but they are all ok - including ones I’ve not met before. I cannot fault them.” They confirmed they had been involved in decisions on how they wanted their care provided and fully involved in setting up their programme of care.

An expert by experience completed telephone interviews with a number of people who received a service from Essex Cares South East to gain their views. An expert by experience is a person who has had experience in using this form of service and assists the compliance inspector in their visit and gaining information. Comments from the visits and interviews have been added to this report where possible.

The expert by experience reported that during their interviews, those people who had some problems still mainly praised the care and the service and would recommend it. People reported that the care staff were unhurried, helpful and also very sensitive. They added the care staff were very respectful of their home life and choices and the agency listened to them from the start and respected their choice.

People who received a service were positive about the care and service. They all confirmed that they had been involved in decisions on how they wanted their care provided and they had regular contact with the manager and care worker to ensure that if their care needs changed they received appropriate support. They had been fully involved in setting up their programme of care. People spoken with understood the care and treatment choices available to them and told us they were involved in making decisions about their care.

People had been given appropriate information and support regarding their care and had been fully involved in the assessment of their needs and the programme of care arranged.

People were complimentary about the care they received and stated they felt their privacy and dignity had been respected. Comments included, “They are ever so kind,” “It is a wonderful service” and “I am going to write a letter of thanks.”

People told us that care workers had the knowledge and skills to meet their needs.

Comments received from the provider’s quality assurance included “They are a caring and efficient team,” “It is a very good service – we are well pleased,” “The carers are first class – we cannot fault them” and “I cannot praise them enough.”