This inspection was an announced inspection and took place on the 12, 14 and 21 June 2017. It was announced with 48 hours’ notice because the service was a domiciliary care agency and we wanted to make sure the registered manager was available. Generations Care Agency provides personal care for adults living with a range of health conditions in their own homes. At the time of our inspection there were 119 people receiving personal care from staff at the service. This included mostly older adults and some adults aged 58 to 65 years.

There was a registered manager at this 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 our last inspection in February 2015 we rated the service as ‘Good’ overall. At this inspection we found the service remained ‘Good’ overall.

People felt safe when they received care from staff at the service. Both they and their relatives were confident their homes and personal possessions were safe when staff were present.

People were protected from the risk of harm or abuse. Staff knew how to recognise abuse and they were informed and confident to report any concerns about people’s safety if they needed to. The provider acted to ensure people’s ongoing safety following alleged safeguarding concerns.

Overall people received timely care from staff who were safely recruited and deployed. Related management and emergency planning measures helped to ensure people’s safety.

Risks to people’s safety associated with their health and environment were assessed before they received care and regularly reviewed. People’s medicines were safely managed. Staff supported people in a safe, skilled and timely manner.

People and relatives were happy with the care provided. People were supported to maintain and improve their health and nutrition by staff who were supported, trained and knowledgeable to ensure this. Staff referred to, understood and followed any instructions from external health professionals for people’s care when they needed to.

Staff understood and followed the Mental Capacity Act (2005) to obtain people’s consent for their care when required and to ensure their rights and best interests.

Staff were respectful, kind, caring and promoted people’s dignity, independence and rights in care. Staff knew people well and had good relationships with them and their families. Staff understood people’s care preferences and daily living choices and followed what was important to people for their care.

People and their families were involved and mostly informed to understand and agree the care they could expect to receive and for its ongoing review. Staff understood and knew how to communicate and engage with people. People’s related care plans often helped to ensure this.

Improvements were in progress to provide and communicate key service information for people in a way they understood.

People’s care was personalised and helped to ensure their independence. People mostly received individualised, timely and consistent care. Management actions in progress following related feedback they obtained from people and relatives, helped to further ensure this.

People and relatives knew how to make a complaint about the service if they needed to. The provider regularly sought views from people, relatives and staff about the service, which they used to inform and make service improvements when required. Recent feedback obtained from this showed overall satisfaction with the service.

The service was well managed and led. Staff were informed, supported and understood their role and responsibilities for people’s care. The provider’s governance arrangements helped to ensure the quality and safety of people’s care, ongoing accou

People had care records and understood the care and treatment choices available to them. The information about how people needed to be supported was not always included in the care records to ensure they received safe and consistent care.

People we spoke with told us they were cared for by the staff team who generally knew what to do to assist them. One person told us, “The staff have been great. I don’t want anything to change.” Another person told us, “It would be better if all the staff knew how to support me. Sometimes I have different staff who don’t know me as well.”

The staff received training that was appropriate for their individual needs and provided them with the information they needed to care for the people living in their own home.

We looked at safeguarding procedures; this is how the service ensured people were protected from harm. We saw suitable systems were not in place to support and protect vulnerable adults and protect them.

There were quality monitoring systems in place and people were able to share their views and opinions about the service. People’s views were not used to develop the service and maintain quality.

We spoke to people who used the service and their relatives who told us they were very happy with the service. Two relatives told us the same carers attended and that there was good continuity of care. One relative said this was important to them. One person who used the service said staff were always very pleasant and that she was well looked after. The same person told us they had participated in two trips arranged by the agency and had enjoyed them. Another relative told us that staff were usually on time and could only remember one occasion when they had been very late. Another relative told us she rang the office or the out of hours number if staff were late but said this happened only occasionally. Relatives we spoke to said people were treated with dignity and respect.

People told us “they were very satisfied with Generations and they fitted in with any change to times I have”

They told us” I get the same carer each time, and they are always on time,”

We were told that families are happy with the care their relative receives especially as when they do not live near by they know some one is going in.

We were told that they feel comfortable with the care provided and that the agency is “wonderful and l could not manage without them.”

We were told that they all had a care plan and people were aware of its contents.

Generations Care Agency provides personal care to people in their own homes in the Chesterfield area.

This inspection took place on 2 and 4 February 2015. It was announced with 48 hours notice because the service was a domiciliary care agency and we wanted to make sure the registered manager was available.

There was a registered manager at the service at the time of our inspection. 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.

Since our previous inspection visit in February 2014 we had received a significant amount of information of concern. The key issues from this information concerned calls being late or missed. We looked into these issues as part of our inspection. The registered manager confirmed that the information we had received had been correct in most cases. We found the provider had taken action to improve this. Feedback from people using the service confirmed that the service had improved and was reliable.

People using the service were protected from the risk of abuse because the provider had provided guidance to staff to help minimise any risk of abuse. Decisions related to peoples care were taken in consultation with them, their representative and other healthcare professionals, which ensured their rights were protected.

We found the provider had not identified what action staff were to take in risk assessments to ensure risks to people’s safety and welfare was minimised. We have made a recommendation about the management of risk.

People told us the care staff were caring and kind and they received the support agreed in their care plan. They were involved in the planning of their care and support and independence was promoted. Complaints were well managed.

The registered manager at the agency was familiar with the needs of the people using the service and staff felt supported by the management team. There were systems in place to enable people to give feedback on the service and auditing systems monitored the quality of the service.