Halo Homecare provides domiciliary care and support to 40 people living in their own homes in Kingston and surrounding areas. This service includes assistance with bathing, dressing, eating and medicines, home help covering all aspects of day-to-day housework, shopping, meal preparation and household duties. We only looked at the service for people receiving personal care during this inspection as this is the service that is regulated by CQC.

At the last Care Quality Commission (CQC) inspection in October 2015, the overall rating for this service was Good. At this inspection we found the service remained Good. The service demonstrated they continued to meet the regulations and fundamental standards.

People remained safe in their homes. Staff could explain to us how to keep people safe from abuse and neglect. People had suitable risk assessments in place. The provider managed risks associated with people’s homes, to help keep people and staff safe. Recruitment practices remained safe. Medicines continued to be administered safely. The checks we made confirmed that people were receiving their medicines as prescribed by staff qualified to administer medicines.

People continued to be supported by staff who received appropriate training and support. Staff had the skills, experience and a good understanding of how to meet people’s needs. People told us that staff encouraged them to make their own decisions and gave them the encouragement, time and support to do so. 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. When required staff supported people to access a range of healthcare professionals.

People and relatives told us staff were caring, kind and efficient and 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. The provider had arrangements in place to respond appropriately to people’s concerns and complaints.

Staff we spoke with described the management as very open, approachable, positive and easy to get on with. Systems were in place to monitor and improve the quality of the service. The provider had effective quality assurance systems to monitor the scheme’s processes. These systems continue to help ensure people received the care they needed as detailed in their support plans.

During our visit to the registered office we spoke with the company owners and registered manager. After the visit we spoke by telephone with five people who used the service and their relatives and two care support staff.

People we spoke with were very happy with the care that they or their relative received. Comments included, “Always provide excellent service, “More than happy with them, very dedicated”, “They go above and beyond” and “A first class service”. They told us that staff treated them with respect and consideration and provided care with sensitivity and understanding of their needs. “They do it so well; respecting what I want” and “They always ask what I would like done”.

We saw that people’s needs were assessed and that person-centred care plans were designed that considered people’s individual circumstances, and their immediate and longer-term needs.

We found that appropriate arrangements were in place for the recording of medication administration and documents were signed and dated. We saw that effective recruitment and selection processes were followed and suitable checks undertaken before staff began work.

The provider regularly monitored the quality of service provision and staff performance. Quality assurance reviews were undertaken twice yearly in people’s homes and a service user satisfaction survey was conducted annually. The latest survey results reported that all respondents would recommend the service to friends and family.

During our visit we did not speak directly with people using the service. Instead we interviewed them by telephone and looked at questionnaires they had completed. People told us "They provide excellent carers". "The carers are very friendly and provide a good lunch". "Stimulation as well as care is very important and we couldn't have better carers". They felt treated with dignity and respect. They were involved in choosing the care and support they needed and it was provided when they needed it. They said the quality of care was very good and they felt safe receiving the service. "I look forward to seeing them". They found staff friendly, competent and flexible in adapting their working practices to provide the good quality of care. They did not comment on the support staff received or the safeguarding procedures in place. They did tell us that there was frequent contact with the agency to identify that they were satisfied with the service they were getting and with the staff providing it. They were also aware of the complaints procedure.

We saw that people using the service were provided with suitable information to decide if they wished to use the agency. There were appropriate policies and procedures in place including safeguarding and records were well kept and up to date. Staff were supported to carry out their roles and responsibilities and there was a robust complaints policy and procedure that was accessible to people using the service.

This inspection took place on 27 and 28 October 2015 and was announced. We told the provider one day before our visit that we would be coming. At the last inspection on 21 January 2014 the service was meeting the regulations we checked.

Halo Homecare provides domiciliary care and support to 43 people living in their own homes in Kingston and surrounding area.

The service had a registered manager 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.’ The registered manager was on annual leave on the day of our inspection and we met with two directors, who were also the owners of the domiciliary care agency.

People told us they felt safe with the support they received from staff. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service and staff how to report potential or suspected abuse. Staff we spoke with understood what constituted abuse and were aware of the steps to take to protect people.

People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe. The provider ensured there were safe recruitment procedures in place to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

Staff received training in areas of their work identified as essential by the provider. We saw documented evidence of this. This training enabled staff to support people effectively.

Appropriate arrangements were in place in relation to administering and the recording of medicines which helped to ensure they were given to people safely.

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. Records showed people were involved in making decisions about their care and support and their consent was sought and documented.

We saw dietary requirements for people were detailed in their care plans for those who needed support with food preparation. Staff told us they always ensured the person had food and drinks available to them when they were on their own.

People were involved in planning the support they received and their views were sought when decisions needed to be made about how they were supported. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.

Staff respected people’s privacy and treated them with respect and dignity. Staff supported people according to their personalised care plans.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner.

Staff gave positive feedback about the management of the service. The directors were approachable and fully engaged with providing good quality care for people who used the service. They encouraged a positive and open culture by being supportive to staff and by making themselves approachable with a clear sense of direction for the service.

The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions and action plans were developed where required to address areas for improvements.