Essex Dementia Care is a domiciliary care service providing personal care and support for people who are living with dementia in their own homes. At the time of our inspection they were providing personal care to three people and a range of other non-regulated services to approximately 35 people.

This inspection took place on 14 September 2016, and it was announced.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC 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.

Relatives told us they felt the service was safe. Staff understood their responsibilities with regards to safeguarding people and they had received effective training. There were systems in place to safeguard people from the risk of possible harm.

There were sufficient members of staff employed by the service and the provider had robust recruitment procedures in place.

The service did not routinely provide support to people to administer medicines however there were effective systems in place to administer medicines to people safely should it be required.

People were supported by consistent staff who were knowledgeable and skilled. Staff were trained and competent in their roles and were supported by way of supervisions and performance feedback.

People received person centred care. People’s needs had been assessed and they had been involved in planning their care and deciding in which way their care was provided. Each person had a detailed care plan which was reflective of their needs and included personalised risk assessments that gave guidance to staff on how individual risks to people could be minimised.

Consent was sought from people prior to receiving care and staff involved people in decisions regarding their support.

Positive relationships had developed between people and members of staff. Staff were caring, helpful and understanding. They provided care in a friendly, professional manner and maintained people’s privacy and dignity.

There was a positive, open culture at the service. People, relatives and staff found the registered manager approachable. Staff felt motivated in their roles and spoke positively of the team work in place at the service. People and their relatives knew who to raise concerns to and the provider had an effective process for handling complaints and concerns.

Feedback on the service provided was encouraged and plans had been developed with a view to continuously improve the service. There were effective quality assurance processes in place.

Our inspection team was made up of one inspector. We spoke with one person who used the service, the manager, two staff and three relatives of a person who used the service.

We looked at three people’s care records. Other records viewed included training records, health and safety checks, medication records, quality assurance audits and satisfaction questionnaires completed by the people who used the service, relatives, staff and health professionals who were involved with the people who used the service.’

We set out to answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard people they supported. People told us that they felt their rights and dignity were respected. Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations.

Is the service effective?

People were happy with the care and support they received. No one raised any concerns with us. This was consistent with the positive feedback received from people as reported in the provider's own quality assurance survey. All of the staff we spoke with were knowledgeable about individual people's care needs, and this knowledge was consistent with the care plans in place.

Is the service caring?

We spoke with three relatives of people being supported by the service. We asked them for their opinions about the staff that supported their relatives. Feedback from people was positive, for example, “The staff are always on time”, “They do what my relative asks them." Another person said “I feel I can talk to the staff about anything."

Is the service responsive?

We saw that care plans and risk assessments were informative, up to date and regularly reviewed. The registered manager responded in an open, thorough and timely manner to complaints. This meant that people could be assured that complaints were investigated and action was taken as necessary. Staff told us the manager was approachable and they would have no difficulty speaking to them if they had any concerns about the service.

Is the service well-led?

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times.

During our inspection we spent time at the registered office reviewing records and speaking with people by phone. We also attended a local day centre to meet with staff from Essex Dementia Care and people who used the service.

Relatives spoke positively about the service. One person commented, “The whole experience with Essex Dementia Care is really helpful." Care plans we reviewed showed that the support provided was based on an assessment of people’s needs.

Staff we spoke with were enthusiastic about their work and told us they were well trained and felt supported. However, supervision meetings did not take place two monthly which the provider told us was their standard. We also found that although informal support systems were in place, staff did not receive an annual appraisal.

During our inspection we found that although some systems were in place to monitor the quality of care, views of people who used the service and their families were not regularly sought. However, we saw that a satisfaction survey had recently been developed and the manager told us this would be sent out within the next two months.

We found that the manager had notified the Care Quality Commission of significant changes to this service earlier this year. As a result, a new certificate of registration had been issued. However, an up to date statement of purpose was not available.

This was a follow up inspection to look at the three compliance actions we had made at our inspection on 21 November 2012. At this return visit we found that matters had improved. In January 2013 we received an action plan stating what action would be taken by the provider to reach compliance. At this inspection we found that actions had been put into place.

We found that a robust recruitment process had been put in place to protect people who used this service. We the Care Quality Commission had received notification about significant changes affecting this service. We had been told of the change in responsible persons. We have altered the registration certificate to reflect these changes. We have been notified of the change in the Statement of Purpose. This information was available to anyone who wanted to know the named individuals who ran this service.

This was the first time this service had been inspected. We spent time at the registered office and met three staff members and spoke with a fourth person who helped run this domiciliary agency. We telephoned three staff and three people who use this service to ask them about their experiences of the service.

We examined care records at the agency and found that assessments and care plans were in place. We spoke with three relatives who were all very positive about the service they received. One person typically told us "We receive a very individualised service based upon a trusting relationship. They have helped our family adapt and make a graceful transition with changes that have occurred in our family."

We examined records of staff recruitment and found that these needed to be further developed to provide a more robust recruitment process that would enhance the protection of vulnerable people.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.