This inspection took place on 6 October 2016.

First Class Care Agency provides a domiciliary support service to enable predominantly older people to continue living at home in and around Harlow. When we inspected the service provided support with personal care to 35 people.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (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.

People were supported in their own home by staff that were able to meet their needs safely. Staff were able to demonstrate that they understood what was required of them to provide people with the safe support they needed to remain living independently in their local community.

People were protected from the risks associated with the recruitment of staff unsuited to the role by the provider’s recruitment procedures. Comprehensive risk assessments were also in place to reduce and manage the risks to people’s health and welfare. There were sufficient numbers of staff employed to meet people’s assessed needs.

People also benefited from receiving personal care and support from trained staff that were caring, friendly, and responsive to people’s changing needs. All staff demonstrated a commitment to providing a service for people that met their individual needs. People had positive relationships with staff.

People’s right to make day-to-day choices about how they preferred their care and support to be provided was respected and this was reflected in their agreed care plans. People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005.

People had the guidance they needed to raise concerns or make a complaint. There were procedures in place to ensure complaints were appropriately investigated and action was taken to make improvements to the service when necessary. Staff and people were confident that if they had any concerns they would be listened to and any concerns would be addressed.

People benefited from a service that was appropriately managed so that people received their service in a timely and reliable way. The manager had values and a clear vision that was person centred and focussed on enabling people to live at home.

As part of our inspection we spoke with five people who used the service, three relatives, four staff, the registered manager and care coordinator.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is the summary of what we found:

Is the service safe?

The provider had effective systems in place to monitor the health, safety and wellbeing of people who used the service. Risk assessments were in place and regularly reviewed.

The provider assessed the needs of people who used the service. We saw that assessments of people’s care and support needs had been carried prior to any care being provided.

The registered manager had a good understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff had been provided with the training they needed which would ensure that they had guidance in understanding how to safeguard people who may be deprived of their liberty. They demonstrated their understanding of what action to take which would ensure people without mental capacity had their best interests protected.

Staff had received training on the safe use and administration of medicines. All staff we spoke with told us they had received regular training with updates to provide them with the necessary skills to administer people’s medicines safely. Risk assessments were in place and a clear record of medication administered had been carried out by staff.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Everyone we spoke with who used the service and their relatives were complimentary about the quality of the care they received and felt their needs had been met.

The provider had systems in place to monitor the quality and safety of the service. These included monitoring the health, welfare and safety of people who used the service as well as assessing the views of people who used the service and their relatives

Is the service caring?

People we spoke with told us that care staff supported them in a kind and caring manner.

Staff we spoke with told us that discussions and reminders about providing personal care in a caring, dignified and respectful manner were often on the agenda at team meetings and one to one supervision meetings.

Is it responsive?

We found that people’s diversity, values and human rights were respected as staff supported people in a way that promoted their privacy, dignity and human rights.

The provider had in place an out of hours, on call system which provided staff and people who used the service with access to support and advice when needed.

Is the service well led?

The provider carried out annual satisfaction surveys which involved people who used the service, their relatives and care staff. Surveys covered all aspects of the service provided. The results from this survey had been analysed by the manager and action plans had been put in place to address any areas that required improvement.

The provider had a complaints, comments and compliments system in place. The provider had taken account of comments and complaints and acted on them.

Staff told us that the registered manager was approachable and supportive. Regular team meetings, supervision and appraisal’s had been provided to support staff in their training and professional development needs. Staff and people who used the service told us that the senior team were always available for advice and support.

During our inspection we spoke with three people who received care from this agency and the relatives of three other people. We also spoke with three staff members.

People we spoke with described the care provided by the agency as, “Good”, “Generally good” and, “Pretty good”. Staff told us of the importance of ensuring people maintained as much independence as possible. One person’s relative particularly commented on this and told us, “They give [my relative] time to do things.”

We saw that people’s needs were assessed before care was provided to ensure that the agency was able to meet each person’s needs. Risk assessments were carried out to ensure that this could be done safely. Each person had a care plan that provided guidance to the staff on the care and support people required.

We found that appropriate arrangements were not in place to ensure that medicines were administered to people safely and audit checks could be carried out.

Staff received regular training and support through one to one and group meetings. This helped them to deliver care safely and to an appropriate standard.

The provider had an effective system in place to regularly assess and monitor the quality of service that people receive. There was an effective complaints system available. We saw that comments and complaints were responded to appropriately.

We spoke with two people and the relatives of three other people who used the service. All the people we spoke with told us that they were involved in discussions of what care was needed and how that care was to be provided. All of the people we spoke with also told us that the care workers treated the person who used the service with dignity and respect. We saw evidence of ways in which this was done in the daily record sheets within the care records.

We looked at the care plans for four people who used the service. These were individual and person centred. The people that we spoke with all told us that they were happy with the care that was provided. A relative said, "They are absolutely brilliant, very helpful and extraordinarily reliable."

Three of the four staff members had started work only after a full and satisfactory Criminal Records Bureau (CRB) check had been received. The fourth staff member was accompanied by an experienced care worker when visits had been made to people's homes prior to the CRB check being received.

A senior care worker made spot checks on staff on a regular basis. The senior care worker had completed a quality check list for each spot check. We saw evidence that when something unsatisfactory was identified steps were taken immediately to address this with the care worker.

In response to the owner's quality assurance surveys, people said they were pleased with the care and support provided for them and they liked the care staff. Families reported that their relatives were much happier since they had started receiving support from the agency and that they considered the care staff to be thoughtful, caring and sensitive.