Halcyon Home Care is a domiciliary care agency that provides personal care to people in their own homes. It provides a service to older adults and people living with dementia. The Care Quality Commission (CQC) only inspects the service being received by people provided with the regulated activity ‘personal care’; help with tasks related to personal hygiene and eating. Not everyone using the service receives the regulated activity. Where they do we also take into account any wider social care provided.

This inspection took place on 27 and 28 November 2018 and was announced. We gave the provider prior notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office. At the time of our inspection the service was providing personal care to 36 people.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good

People felt safe while supported by the staff team who made them feel reassured and relatives agreed. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. The registered manager had the knowledge to identify safeguarding concerns and acted on these appropriately.

People and relatives were complimentary about the staff and the support and care they provided. People received support that was individualised to their specific needs which was kept under review and amended as changes occurred. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were treated with respect, and their privacy and dignity were promoted. People felt the staff supported them in the way they wanted. Staff were responsive to the needs of people and enabled them to improve and maintain their independence with personal care.

Where possible, the registered manager scheduled visits so the same staff went to see people to maintain continuity of care and support. People were informed about the changes to their visits as necessary. The staff monitored people's health and wellbeing and took appropriate action when required to address concerns. People felt confident they would be looked after well and relatives agreed. The service assessed risks to people's personal safety, as well as staff and visitors, and plans were in place to minimise those risks. There were safe medicines administration systems in place and people received their medicines when required.

The service had recruitment procedure that they followed before new staff were employed to work with people. This included ensuring staff were of good character and suitable for their role. Staff training records indicated which training was considered mandatory. The registered manager and senior staff had planned and booked training when necessary to ensure all staff had the appropriate knowledge to support people. Staff had ongoing support supervision and appraisals. They felt supported by the registered manager and senior staff, and maintained good team work.

Staff felt the registered manager and senior staff were approachable and considerate. They had good communication, worked well together and supported each other, which benefitted the people who use the service. The registered manager had quality assurance systems in place to monitor the running of the service and the quality of the service being delivered. The registered manager and the senior team were able to identify issues and improvements necessary and took actions promptly to address the

Halcyon Home Care offers a bespoke in-home care service for older people including companionship, home help, medication reminders and personal care. Some people who use the service have a diagnosis of dementia. The office of the service is located in a residential area Maidenhead, Berkshire and care is provided in surrounding areas. When we inspected, there were 28 people who used the service and 18 staff.

At the time of the inspection, there was 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 location was last inspected under the Health and Social Care Act (Regulated Activities) Regulations 2010. On 10 February 2014 we found the location was compliant with the outcomes we inspected. This is the first inspection of the location under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People received safe care from the service. The staff knew what abuse was, how to safeguard people in the event of suspected abuse and what organisations needed to be contacted. People had risk assessments, care plans and regular evaluation of their care to ensure their safety. Staffing deployment was satisfactory as the registered manager and a team leader oversaw the staffing arrangements for people’s care. People were safely assisted with medicines out of pre-packaged blister packs, bottles and packets from their local pharmacy.

The service was effective in the care it provided to people. Staff attended necessary training to ensure they could provide the best personal care for people. The service ensured that staff had appropriate knowledge and skills to undertake their role. The staff received regular supervision sessions with the registered manager and were able to set and achieve their own employment goals. Recruitment and selection of any staff member was robust and ensured safety for people who used the service. Consent was always gained from people before care was commenced and people’s right to refuse care was respected.

People told us staff were kind and generous. The staff told us they respected people’s privacy and dignity, and explained they wanted people to be as independent as possible. People were able to say how they liked their care, and the service would accommodate their requests. Care provided by Halcyon Home Care was individualised and met people’s expectations. People told is they could change the care they received by liaising with staff.

The service was responsive to people’s needs. People and relatives had the ability to share their compliments, concerns and complaints in an open and transparent manner by communicating directly with the staff. People we spoke with were satisfied with the care and we had received cases of positive feedback about the service from members of the general public.

People who used the service staff commented that the service was well-led. They felt that the registered manager and team leader took time to listen and would often make an extra effort for them. The registered manager was very involved in the service and meeting people’s requests. We found that the management conducted a range of checks to assess the standard of care. This included auditing care documentation to ensure safety, accuracy and opportunity for improvements, if needed. Some people told us they would like to see even more management involvement in the provision of their care.

We spoke with people who used the service, relatives, staff and managers, including the registered manager. People were wholly complimentary about the quality of the service they received with one person describing staff as "really lovely" and said staff went "beyond the scope of what they need to do". Other people described staff as "respectful" and "very well trained". One person said the manager was "very particular about the staff they employed".

Staff felt supported and one, who was new in post found the support helpful in making them feel comfortable in their role. Staff were also motivated and said they enjoyed their work.

People felt they were treated with respect and staff showed regard for their privacy and dignity. People felt able to determine how staff could best support them and meet their needs. People were treated as individuals and their care and support needs were determined largely by them.

People felt safe and staff had a good understanding of their responsibilities in relation to safeguarding. There were measures in place to safeguard people's money and property. There were effective and personalised assurance processes in place to monitor the quality of the service.

During our visit we spoke with staff and people who used the service. From our discussions we learned that staff treated people with dignity and respect.

People that we spoke with and compliments we saw were very positive about the care workers, the manager and owner. Comments included "they always turn up and call if going to be late" and "the same people come to me" and "very much a personal service that has inspired confidence."

Staff we spoke to understood how to support people, assisted them to make choices and maintain as much independence as possible. A member of staff told us "I treat people as I would like to be treated," another told us "I let them do what they can for themself, it's all about what they want."

A person who used the service told us their care worker "supports them to do whatever they need help with," another told us "they help me around the home with things I find difficult.

Staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

In order to protect and support people who used the service, we saw that the provider carried out a rigorous staff recruitment process and provided detailed care plans which assisted staff to deliver safe and effective care.

There were processes in place to monitor the quality of service being provided and we saw that people were involved through detailed assessments, regular reviews and one to one discussions.