We carried out a comprehensive inspection of Everycare a Domiciliary Care Agency (DCA) on 28 and 29 September 2016. A breach of legal requirements was found in relation to records and quality assurance systems. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach and told us this would be completed by the end 18 November 2016 although training was to be ongoing.

We undertook this focused inspection on 27 March 2017 to check that they had followed their plan and to confirm that they now met legal requirements. We found improvements had been made and the provider was now meeting all legal requirements. However, these improvements were not, as yet, fully embedded in practice and need further time to be fully established in to everyday care delivery.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Everycare on our website at www.cqc.org.uk.

Everycare provides support for people who require a range of personal and care support related to personal hygiene, mobility, nutrition and continence. Some people were living with early stages of a dementia type illness or other long-term health related condition. Most people lived reasonably independent lives but required support to maintain this independence.

Everycare also provides 'live-in' support for people who have more complex needs such as frailty associated with old age or long-term health conditions.

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

Care plans were personalised and contained the information required for staff to support people. However, further work was still required to ensure all information about how people made decisions and risks associated with their care and support were recorded.

Staff knew people well and had a good understanding of their needs. There was an open and positive culture which focussed on providing high quality support for people.

Full details of our findings can be found in the main body of the report under well-led.

We undertook an announced inspection of Everycare a Domiciliary Care Agency (DCA) on 28 and 29 September 2016. We told the registered manager two days before our visit that we would be coming. We did this because they were sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure they would be in.

Everycare provides support for people who require a range of personal and care support related to personal hygiene, mobility, nutrition and continence. Some people were living with early stages of a dementia type illness or other long-term health related condition. Most people lived reasonably independent lives but required support to maintain this independence. Everycare also provides ‘live-in’ support for people who have more complex needs such as frailty associated with old age or long-term health conditions.

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

Although staff had a good understanding of the risks associated with supporting people we found risk assessments were not in place to reflect all the identified risks. Care plans were personalised and reflected people’s individual needs however some did not contain all the information staff needed to provide care or evidence the care and support people received.

People’s care was personalised to reflect their wishes and what was important to them. People were supported by staff who knew them well and understood their needs and preferences. People were visited at times that suited them. People were introduced to staff before they provided them with care and they were looked after by a team of regular staff who knew them well.

People and their relatives spoke positively about the care, support and service they received from Everycare. They told us they received, “Superb care,” they said, “Care has been excellent.” They spoke highly of the care staff and comments included, “Some of the carers are absolutely outstanding” and “I can only speak very highly of them”

People received the medicines they had been prescribed, when they needed them. The systems in place meant medicines were well managed.

There were enough staff who had been safely recruited to meet the needs of people who used the service. Staff had a good understanding of the procedures to follow to safeguard people from the risk of abuse. Staff were aware of their individual responsibilities.

There was an induction programme in place and staff received the training and support they required to meet people’s needs. Staff were trained in the principles of the Mental Capacity Act 2005 (MCA) and were knowledgeable about the requirements of the legislation. Best interest meetings had taken place when people lacked capacity to make their own decisions.

Where required staff supported people to have enough to eat and drink and maintain a healthy diet. Staff knew people well and recognised when they may need to be referred to an appropriate healthcare professional for example the GP or district nurse.

People were regularly asked for their feedback about the service and support they received and were aware how to make a complaint. There was an open and positive culture at the service. The staff told us they felt supported and listened to by the registered manager. People were put at the heart of the service and staff were focussed on providing high quality care.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We spoke to people who used the service and found that they expressed their views and were involved in making decisions about their care and treatment.

We examined people’s care plans and saw that their needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One person told us, “All the carers are first rate.”

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We examined staff files and found that appropriate checks were undertaken before staff began work.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. People told us, “I have no complaints whatsoever.”

During our visit we saw that people were being treated with dignity and respect and people’s independence was encouraged. People were spoken to in a respectful way. People we spoke to told us that the staff were polite, friendly and helpful and that their privacy was respected whilst they were supported to maintain their independence. One person told us 'all the carers are very good' and a relative told us that 'the standard of care is very good'.

We saw that people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. People told us if they had any concerns they would report them to the manager of senior person on duty.

Staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

The Provider had effective systems in place to monitor and assess the quality of the service.

Not all of the people using the service were able to tell us about their experiences, however those who could told us “everyone is so helpful, I have never had any issues with Everycare” and “staff always do what you ask them to do, nothing is too much bother”.