This inspection took place on 28 February and 1 March 2017 and was announced.

Everycare Medway/Swale provides care services to people in their own homes mainly in the Medway area. The care provided was tailored to people’s needs so that people could maintain or regain their independence.

Care was delivered to older people some of whom were living with dementia and younger adults with learning disabilities, mental illness and physical disabilities. There were 60 people using the service at the time of our inspection. The care and support people needed ranged from short calls to more intensive 24-hour support packages.

At the last Care Quality Commission (CQC) inspection on 22 July 2014, the service was rated as Good in all of the domains and had an overall Good rating.

There was a registered manager employed 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.

At this inspection we found the registered manager and provider has consistently monitored the quality of their service to maintain a rating of Good.

People continued to experience care that was caring and compassionate. Staff were trusted and well thought of by the people using the service.

People continued to have their needs assessed and their care was planned to maintain their safety, health and wellbeing.

Risks were assessed and recorded by staff to protect people. There were systems in place to monitor incidents and accidents.

Staff had received training about protecting people from abuse and showed a good understanding of what their responsibilities were in preventing abuse.

The provider had updated their policies since we last inspected in line with published guidance and practice in social care.

Procedures for reporting any concerns were in place. The registered manager knew how and when they should escalate concerns following the local authorities safeguarding protocols.

Staff training covered both core training like first aid and more specialised training. They also understood the Mental Capacity Act 2005 and how to support people’s best interest if they lacked capacity.

Staff continued to have good levels of support and supervision to enable them to carry out their roles.

Staff continued to be recruited safely and had been through a selection process that ensured they were fit to work with people who needed safeguarding.

Staff had been trained to administer medicines safely and staff spoke confidently about their skills and abilities to do this well.

People were pleased that staff encouraged them to keep healthy through eating a balanced diet and drinking enough fluids. Care plans were kept reviewed and updated.

There were policies in place that ensured people would be listened to and treated fairly if they complained.

The management team and staff were committed to the values of the organisation and ensured they took these into account when delivering care and support.

People were happy with the leadership and approachability of the service’s registered manager, the provider and the management team.

We spoke with people and their relatives about the care that they received. People told us that they liked the staff and were happy with the support they received. We looked at care records and saw that people had care plans that were reviewed and amended when needed, and which reflected their individual needs.

We spoke to staff about the processes that they followed to ensure that they protected themselves and people who used the service from the risk of infection. Staff were knowledgeable about what they needed to do and what equipment they needed to use.

We spoke with relatives of people who used the service about the staff that provided care. They told us that they were happy with the staff and had always received support when they needed it.

We looked at compliments and complaints received by the service. We saw that the service sent out questionnaires to people who used the service to gather their views of the service and the support they received.

We looked at records kept by the service. We saw that care records, staffing records and complaints records were all accurate and up to date.

We found that the provider had failed to notify the Care Quality Commission of allegations of abuse in relation to a person who used the service as required by the Health and Social Care Act 2008.

People told us that they were involved in planning their care and made decisions about changes to their care plans when needed.

People we spoke with told us staff were very good and looked after them well.

People told us that staff always spoke to them in a respectful manner and were always gentle when they supported them to move around.

People told us the providers talked to them about how the service was run and listened to their views and suggestions.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This inspection was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. Everycare (Medway/Swale) is a domiciliary agency registered with the Care Quality Commission (CQC).

There were 71 people using the agency when we inspected and care and support was delivered to people in their own homes. The agency provided personal care, support with medicines and some complex care and support to people with higher dependency levels. For example for people with acquired brain injuries, people who have had strokes, suffer from epilepsy, mental illness and physical disabilities.

The agency had a manager who was registered with CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the agency and has the legal responsibility for meeting the requirements of the law; as does the provider.

At the last inspection in May 2013, we asked the provider to take action to make improvements to the way they sent notifications about incidents affecting people who used the service to CQC. The manager sent us an action plan telling us how they would make improvements. At this inspection we found that the mangers had kept CQC fully informed and were meeting the regulation.

Managers assessed people’s needs and planned people’s care to maintain their safety, health and wellbeing. Risks were assessed to protect people who received care and for the staff. Managers ensured that they employed enough staff to meet people’s assessed needs. People’s comments included, “The service is very safe” and, “I feel very safe with nice carers”. All of the community nurses and care managers who fed back to us believed the agency provided safe care.

Staff had received training about protecting people from abuse and showed a good understanding of what their responsibilities were in preventing abuse. Procedures for reporting any concerns were in place. Staff reported that they had confidence the registered manager would respond appropriately to any concerns they raised. Managers had access to and understood the safeguarding policies of the local authority.

Managers ensured that they could continue to meet people’s care needs in the event of foreseeable emergencies occurring, such as during periods of extreme weather. The agency took account of the Mental Capacity Act 2005 when planning and delivering care and support.

The agency had robust recruitment policies that had been followed. This ensured safe recruitment practices. Staff backgrounds were checked prior to them starting work. Staffing levels were kept under review and were adjusted according to people’s assessed needs.

People told us that staff met their assessed needs. People told us that they received care and support in a timely manner. People told us that they received their care from staff who were aware of their individual needs on a regular basis. Some people were cared for by their own teams of carers led by a team leader who oversaw the delivery of care.

Managers encouraged people to get involved in how their care was planned and delivered. They respected people’s right to write their own care plans and direct their own care and support. The agency demonstrated that where appropriate they involved other people who were important to individuals receiving care; for example close relatives. This enabled them to appraise people’s likes, dislikes, skills and life experiences. Managers informed people of their rights about making complaints.

People and their families, had been involved in planning their care. Where required, the agency supported people to maintain their health because staff ensured people had adequate intake of food and drink.

People received care from staff who had been trained to meet their individual needs. People told us that staff were well trained. Managers encouraged staff’s professional development and provided training to meet the needs of people who received care. People said, “I feel the service is really good and the carers are trained effectively to support our disabled son” and “Lovely service, the carers are all trained well and staff in the office support the training and have been very professional”.

People told us that staff were caring. The agency provided guidance and training to staff to ensure they understood how to deliver care with respect and compassion.

People told us that managers were approachable and listened to their views. The owners and managers of the agency provided good leadership. This was reflected in the positive feedback given about the agency by the people who experienced care from them.