The office is located in Coalpit Heath. The services provided include companionship services, home help services and personal care. People can receive one visit or continued visits and overnight support can be provided. The service provides support for older people, some who are living with dementia, as well as people with physical or learning disabilities. The service is a privately owned company and the providers were involved in the day to day management of the service.

At the time of the inspection the service was providing personal care to 70 people.

There was a registered manager for the service, who was also 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 and associated Regulations about how the service is run. We refer to the provider and registered manager as the registered manager throughout this report.

People remained safe in their homes. Staff and the office team knew how to keep people safe from abuse and avoidable harm. People were protected by detailed risk assessments in place. The provider managed risks associated with people's homes, to help them and staff stay safe. Recruitment practices remained safe. Medicines management continued to be carried out safely. Checks confirmed that people were receiving their medicines when needed.

Staff were providing support in line with the Mental Capacity Act 2005. People were supported to eat and drink sufficient amounts to meet their needs. Staff also supported people to access the support of a range of healthcare professionals.

People and relatives told us staff were caring, kind and supportive. People also said staff respected their privacy and treated them with dignity. People's needs were assessed before they started to use the service and care was planned and delivered in response to their needs.

People were supported with their needs by a team of staff with a very in-depth knowledge of how to support people with their needs. Staff were supported to use innovative approaches to deliver personalised and very flexible care.

People were actively encouraged to be involved in all aspects of their care and support was planned. The service was run in a very flexible way and responded quickly to people's changing needs or wishes.

People were fully involved in deciding how they wanted to be cared for and supported. This process began from the first meeting with the registered manager or a senior member of staff. Care plans were written in a person centred way and reflected how people wanted to be supported with their range of needs. People’s care plans set out their full range of care needs and were updated after care reviews and when people’s circumstances changed.

People felt very able to raise concerns or make a complaint. The provider took concerns and complaints seriously. People's views and opinions were sought. Feedback was used to drive improvements.

There were systems for staff training and supervision. These systems continued to help ensure people received the care they needed in a safe way and to a high standard. All staff completed full induction training and they worked alongside experienced staff when they first started work. Staff had their competency assessed. This was to make sure they were safe before could be allowed to work on their own.

Staff we spoke with felt that the management was very open, approachable, and positive. They said that the registered manager who was one of the provider’s was easy to get on with. Systems were in place to check and improve the quality of the service.

People who used the service, relatives and healthcare professionals we spoke with all gave us very high praise of the leadership of the service. The registered manager and staff we spoke with understood the

We carried out an announced focused inspection of this service because we had received some information of concern from an anonymous source and we wanted to check this out. We contacted the registered manager at 5pm the day before our visit to tell them we would be visiting the following morning. We have only looked at the areas of Safe and Effective as the concerns sat within this area.

This report only covers our findings in relation to these specific areas. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Fourways Care Ltd’ on our website at www.cqc.org.uk.

At the time of this inspection the service was providing support to 80 people who lived in their own homes. The areas they covered included South Gloucestershire and Bath and North East Somerset (BaNES).

The service has 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 and associated Regulations about how the service is run.

At this inspection we have looked at staff recruitment procedures and staff training. We have assessed how the service allocates calls to people using the service and how they monitor that the calls were made and not missed. We checked the measures in place to monitor that people reached their medicines as prescribed, where they were assisted by the support workers.

People using this service can expect to be looked after by support workers who were only recruited following robust procedures. These procedures ensured that unsuitable workers were not employed.

Those people who were assisted by support workers with their medicines were not at risk. This was because the staff were well trained, their competency was checked and the records kept of medicine administration were audited on a monthly basis to identify any discrepancies.

Support workers were well trained. Those staff who assisted people to move and transfer received practical manual handling training with the local authority. The service had plans in place to provide in-house moving and handling training with a qualified trainer and develop an equipped training suite.

The concerns we received were not substantiated. There were no breaches of regulations found during this inspection.

The inspection was announced. Forty-eight hours’ notice of the inspection was given to ensure that the people we needed to speak with were available. The inspection was undertaken by one inspector.

Fourways Care is a small family run domiciliary care service. They provide care and support services to people living in their own homes. The service is provided to people who live in the South Gloucestershire area. At the time of the inspection they were supporting six people with a personal care service and others who were provided with services that do not come within the remit of their Care Quality Commission registration (13 in total). The service currently had nine support workers.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The registered manager and support workers were knowledgeable about safeguarding issues. They knew the appropriate actions to take if concerns were raised and who any concerns should be reported to. All staff received safeguarding adults training. Robust recruitment procedures were followed to ensure only suitable staff were employed. Appropriate steps were taken to protect people from harm.

Risks to people’s health and welfare were identified and managed to either reduce or eliminate the risk. The level of support people needed with their medicines was identified in their care plan. Staff received safe medicines administration training to ensure they were competent to undertake the task and their competency was rechecked.

Staff completed a training programme to enable them to carry out their roles and responsibilities. They received support from the registered manager and senior staff. Support workers were expected to complete additional qualifications in health and social care when they had completed their probationary period.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework to assess people’s capacity to make certain decisions. Support workers ensured that people consented before any care or support was provided.

Where people were assessed as needing support with food and drink, support workers would deliver the assistance as described in the person’s care plan. People were supported to see their GP and other healthcare professionals.

The support workers and the registered manager had good, kind and friendly working relationships with the people they were looking after. Staff ensured people’s privacy and dignity was maintained at all times.

People received the care and support they needed because the service had good systems in place to assess people’ needs and then plan their care. Support workers looked after people in the way they preferred. People were encouraged to express their views and opinions about how they wanted to be looked after.

Measures were in place to monitor the quality of the service. The registered manager ensured that people received the service they expected and it was safe, effective and caring. They used any feedback from people to make improvements and learned from any complaints, accidents or incidents to prevent further occurrences.

We carried out an inspection at Fourways Care . This helped us to answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

At the time of our inspection people were receiving support to go out socially or for help in the home. No-one was receiving personal care, which the agency is registered to provide. We could not make a judgement about the provision of personal care to people at the time of the inspection, but looked at the systems in place.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service told us they felt safe and relaxed with staff. One person told us "the staff look after my money and belongings when we are out". The provider had policies and procedures for staff to follow with regard to safeguarding of adults and whistle blowing. The staff were trained to recognise when the safeguarding of adults was required and the policies clearly outlined the duty of staff to report concerns.

People were assessed and their care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw the service had identified and managed risks in relation to the health and safety of people who used the service. The care plans we looked at contained detailed risk assessments and the action taken to minimise risk.

All staff had an enhanced Disclosure and Barring Service check and had completed appropriate training. People told us the staff were competent in meeting their support needs.

Is the service effective?

We looked at three support plans in detail for people who used the service. We saw that an assessment had been completed before the service started and the information was used to develop their support plan. There was sufficient information to enable staff to meet individual needs.

People told us that they had been fully involved in contributing to their support plan and they were aware that changes were made when required. One person told us, “When I lost my balance they (the care workers) made sure I had my sticks and trolley with me”. People told us that they were taken to healthcare appointments if needed. The staff we spoke with had known people's individual support plans and preferences.

Is the service caring?

People who used the service told us they were happy with the care and support provided by the agency and they had been involved in assessments to decide if the service could meet their needs. One person told us, "They [staff] are very caring, thoughtful and kind and make sure I don’t stumble”.

Is the service responsive?

We saw that staff maintained detailed daily records of the support they provided. Appointments were planned and recorded. Support plans were updated where necessary. People told us that the staff were flexible and would take them out in the community wherever they wanted to go. They told us that staff were always on time and did not rush them.

Is the service well-led?

People who used the service were encouraged to give feedback about the services they received. Six monthly reviews and telephone quality assessments had been recorded. People had made comments at their reviews, one person had commented “they [the staff] are brilliant” and a relative said, “spot on, very happy”, and they had signed the reviews.