Farndale House Care and Support Services is a domiciliary care agency that supports people who live in their own home. The agency is managed from Farndale House Residential Care Home, a small care home that is operated by the same registered provider. On the day of the inspection there were 42 people using the service.

At the last inspection in March 2015, the service was rated as Good overall, with the well-led section being rated as Outstanding. At this inspection we found that the service remained Outstanding in well-led and Good in all other areas.

The registered provider continued to lead the team with a positive and pro-active style of management, and they went ‘over and above’ their duties and responsibilities. They provided us with a variety of evidence to demonstrate that leadership at the service continued to be ‘outstanding’.

There continued to be sufficient numbers of staff employed to make sure people received the support they needed, and those staff had been safely recruited. People told us they felt safe whilst staff were in their home and when they went out into the local community with staff.

Staff had continued to receive appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the support people required with medicines and on how to protect people from the risk of harm.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind, caring, compassionate and patient. They respected people’s privacy and dignity and encouraged them to be as independent as possible.

Care planning provided a background about the person and the level of support they required. Care plans were reviewed regularly to ensure they provided an accurate and up-to-date record of the person and their day to day needs.

People were given the opportunity to feedback their views of the service provided and were encouraged and supported to express their concerns or make a complaint, although no-one receiving a service or their relatives had felt the need to complain.

The management team carried out audits to ensure people were receiving the care and support that they required, and to monitor that staff were following the policies, procedures and systems in place.

Further information is in the detailed findings below.

This inspection took place on 12 March 2015 and was announced. We previously visited the service on 17 October 2013 and found that the registered provider met the regulations that we assessed.

The service is registered to provide personal care for people who live in their own home. On the day of the inspection there were 33 staff working for the agency. The agency office is located at the same address as Farndale House Residential Care Home. It is located in Beverley, a market town in the East Riding of Yorkshire. There are parking facilities for staff and visitors.

The registered provider is not required to have a separate registered manager in post as the service is managed by the registered provider. 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.

All staff had received training on safeguarding vulnerable adults from abuse. Care workers displayed an understanding of the action they needed to take if they became aware of a safeguarding incident. There was a complaints procedure in place and people told us that they would not hesitate to contact the agency office if they had a concern. However, everyone we spoke with told us that they had never needed to raise a concern or make a complaint.

Staff were recruited following robust recruitment practices and there were sufficient numbers of staff to meet the needs of people who received a service.

Risk assessments had been completed that recorded individual risks to people and risks associated with a person’s home, and how these should be managed. People told us that, if their care plan recorded they needed assistance from two members of staff, they always received this level of support.

Staff received induction training and on-going training including training on the Mental Capacity Act 2005 (MCA). This meant that care workers understood the principles of capacity and decision making.

Peoples’ nutritional needs were assessed and people told us they were happy with the assistance they received with the preparation of meals. People also told us that their medication was administered safely.

People told us that staff really cared about them and supported them to be as independent as possible. They also told us that staff respected their privacy and dignity.

Care plans were regularly reviewed to make sure that staff had an up to date record of a person’s needs. People told us that the service provided by agency staff was ‘over and above’ what was required.

People who received a service, relatives and care workers told us that the service was well managed. We received only praise for both managers and care workers. Care workers told us that they were well supported and that they felt valued by managers.

As part of this inspection we spoke with five people who used the service or their relative, two care workers, a manager and the registered person. We also checked the care records for two people who used the service. This helped us to reach a judgement about the service that people received.

We saw that people had care plans in place that recorded their individual care and support needs and that these were kept up to date. People told us that they received the level of care that had been agreed with the agency. The support that people received with taking their medication met their needs and was provided in a safe way.

Staff had been recruited following robust recruitment and selection procedures and this ensured that only people who were considered safe to work with vulnerable people had been employed. There were sufficient numbers of staff to ensure that people received a consistent service from a regular group of care workers. One relative told us, “Generally the same two ladies attend – my wife seems happy with them”. Staff told us that they were well supported by the managers.

Quality monitoring had identified improvements that needed to be made. It had been identified that some people were not aware of the complaints procedure and we saw that action had been taken. One person told us about the recent survey and said, “I told them the same as I have just told you – the care is wonderful”.

We spoke to two people who received a service from this domiciliary care agency. They told us that staff respected their privacy and dignity and encouraged them to do as much as they could for themselves. One person said, “The staff are more used to me now and know what I can and cannot do. They always listen to me”.

People told us that the staff did what they wanted them or needed them to do. One person said, “The staff are wonderful – I have no problems at all” and another said, “Personal assistants and office staff are very helpful. They are always willing to provide extra support”.

People who used the service told us that the staff were skilled and appeared to be well trained. One person said, ‘They have all been good’.

People told us that they were consulted about their satisfaction with the service they received. They said that they were very satisfied with the service they received from the agency. They said that they had not had reason to complain but that they would be comfortable discussing concerns with any of the agency staff and that they had always found them to be helpful.