This inspection took place on 21 October 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in the office.

Everycare (Bristol) Limited provides personal care to people in Bristol and surrounding areas. They offer a range of services to individuals who live in their own homes and need support or care. At the time of this inspection there were 42 people receiving personal care.

At the last inspection of the service in 20 October 2014 we found the service was meeting the regulations.

There was a registered manager in place. 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 and associated Regulations about how the service is run.

Staff were not always recruited safely. All the relevant safety checks had not been completed before staff started work. Some files did not contain appropriate references and gaps in employment had not been explored when staff were interviewed to make sure they were safe to work at the agency. This put people at risk from unsuitable staff.

We found that medicine administration records lacked details around what medicine had been given. This could put people at risk of not receiving their medicines as prescribe.

Staff were not being regularly supported and developed. This meant that staff may not have the knowledge and skills to care and support people effectively.

The registered manager did not always submit notifications of significant events to the Care Quality Commission as required by law.

People were protected because staff could describe how they would recognise the potential signs of abuse and were confident in reporting and whistleblowing. The registered manager managed risks to people and always report concerns to the local safeguarding authority as required. People were kept safe by staff who understood the risks to them and could manage those risks.

There were systems in place to keep people safe through risk assessment and the management of risk to people. However, some areas of potential risk to people had not been assessed or recorded.

People received care that reflected their needs and preferences. Care plans reflected the care that people received although not all care plans had been reviewed in accordance with the provider’s policy to make sure the care plans was still appropriate and met their needs.

People were enabled to consent to the care and support they received. People were supported to maintain their day to day health and receive food and drink when required. People were supported by a staff team who were caring and treated people with kindness and respect. Most people received their care visits at the expected times and they were always informed if care staff would be arriving late.

People were enabled to make day to day choices around their care. People's privacy, dignity and independence were protected and promoted by care staff.

People were aware of their care plan and felt involved in its development. People felt able to raise concerns and complaints if needed and told us these were taken seriously and resolved.

People felt involved in the service and some people told us they had contact with managers and office staff. People were supported by a staff team who were motivated and felt supported by the registered manager. Quality assurance systems were in place but needed development in order to identify all areas of improvement required in the service.

We identified that the provider was not meeting regulatory requirements and was in breach of three Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

On the day of our inspection the agency provided support for approximately 60 people. During our inspection we spoke with four people and two relatives of people who received a service from Everycare (Bristol). We also spoke with the provider, manager and five other members of staff who worked at the agency.

People told us they were happy with the service they received. Comments included: “the carers are great, I can’t fault them” and “they (the agency) are very good, I would recommend them to other people”.

People told us they were involved in the planning of their care and support. Records showed that people were fully involved in the meetings. Their comments and opinions were taken into account when care plans were reviewed.

People’s needs were assessed and care was planned and delivered in line with their individual care plan.

The provider had systems in place to ensure that visits to people were not missed. People told us that they were contacted by the agency if the time of their visit needed to be changed.

The provider had effective recruitment and selection processes in place. The provider was able to locate all the documents needed for the purpose of the inspection visit. However, they were not always readily accessible.

The service had effective processes in place to monitor the quality of the service provided. People were asked to feedback on the service and we saw that people’s feedback was analysed and actions taken to improve the service.

We spoke with five people (or their families) who use the service. Two of the people we spoke with received personal care from the service the other three receive services which we do not regulate.

People told us that they were very happy with the care that they receive from the agency.

We were told by the family of a person who uses the service "I have to say they are they best carers I've ever come across" and "They are really bubbly and I really feel that they have added to mum's improvement - they make mum laugh".

We were told that the care workers communicate well with the person using the service and their families.

We were told that care workers are usually on time and the odd time that they are late it is due to the last appointment running over.

One person told us "I have total confidence in them".

People told us that they are treated with dignity and respect and that care is provided in a manner which includes the people who use the service.

People told us that the care workers always ask for consent prior to carrying out any personal care. We were told by a family member that "they always ask her what she wants or needs".

We were told by the family of a person using the service that the care workers encourage the person using the service to receive the personal care.

People told us that care workers always wash their hands when they arrive to provide personal care and that they always have gloves and aprons with them which they use.

The manager told us that the agency supported 39 people in their own homes.

We spoke to six people and four relatives of people who received a service from the agency. Everyone we spoke with said that the carers were very good. Comments we received from people included; “The carers are absolutely wonderful and I’m over the moon with the care I receive”. “All in all they are pretty good” and “I have no problems, they provide a really good service and the staff are always polite”.

People told us that the manager and senior staff at the agency were very approachable and dealt with any problems quickly and efficiently. They also told us that they were kept informed by staff if they were going to be late for a visit.

We saw that people were assessed before the agency began to provide a service to them to ensure that people’s needs could be met. We viewed twelve people’s care records and saw that these were up to date and well maintained.

Staff we spoke with told us they felt well supported in their roles, and the senior staff were very approachable. We also saw that staff were provided with specific training to meet people’s individual needs. One person said “The staff always listen to what I have to say and do things the way I like them done”.

People we spoke with told us that they knew how to raise a concern with the agency, and felt confident that their concerns would be dealt with. We saw that staff had received training in safeguarding adults.