The inspection took place on 14 September 2016 and was unannounced. We also made a visit to the service on 24 November 2016 to check on some further information received by Care Quality Commission (CQC).

The agency was last inspected on 22 August 2013 and at that time did not provide personal care support to anybody living in their own home.

The agency office is situated in St Mary’s hospital Warrington and is part of the St George

Healthcare Group. St Mary’s hospital provides specialist services for people with acquired brain injury and autistic spectrum conditions in a low to medium secure or locked environment.

Focus on Care is a domiciliary care agency providing personal care to people living in their own homes. At the time of our inspection the agency was providing support for 34 people living in the community. The Care Quality Commission has inspected this service in relation to those people who have been assessed as needing personal care.

The agency had a Registered Manager. 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.

The risk of abuse was minimised because there were clear policies and procedures in place to provide staff with information on how to protect people in the event of an allegation or suspicion of abuse.

Staff had receive training to support them with the safe administration of medicines to people they supported.

Suitable recruitment processes and checks were in place to minimise the risk of unsuitable people being employed to work with vulnerable people.

Staff received induction and regular training updates to equip them with the knowledge to fulfil their role.

People were supported by an enthusiastic caring staff team.

Staff had good relationships with people who used the service and we were told staff were caring and attentive to their needs.

The staff took account of people’s wishes, likes and dislikes when providing support.

People were provided with information regarding the agency’s complaints procedure and they told us they knew how and to whom they could complain.

There was strong leadership at the agency were staff told us they felt supported and enabled to do their job and develop.

At the time of this inspection the children and adults who used the service were not in receipt of personal care or nursing care within their home. The services they recieved included general support around their homes and within the community. Due to this we were unable to speak to people who used the service or people who commissioned the services of the agency. However, we did look at what systems were in place in relation to care planning; medicines management; staff recruitment and complaints.

People who use the service and their relatives told us good things about the service they received. Comments included “respectful always”, “they are very nice to me”, “they are there for the family” and “they keep in touch with the family all the time.”

We spoke to a representative of a local authority who commissions care packages from Focus on Care Ltd. They told us that they “do pre visits to people” to get to know them before the service begins and that they “understand people’s needs and work well with other professional in planning people’s care.”

In relation to planning people’s care and support we received positive comment which included my relative “loves it, she goes to all kinds of places”, “fantastic service, they really do care.” The relative of one person who uses the service told us that they stimulate them well by supporting with different, varied activities.

People who use the service and their relatives told us that the manager of the services keeps in contact with them to help ensure that they are receiving the service they need. Their comments included “they are there for the family” and “I can talk to them if I have problem.”

A representative from a local authority who commission services from Focus on Care Ltd told us that the service provided a “consistent service and good planning” for people.