This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. The service provides care and support to adults with a range of needs.

This inspection took place on 21 June 2018 and was announced. At the last inspection this service was rated as good. At the time of our inspection visit 54 people were using the service. At this inspection we found evidence to support the rating of good.

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. 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 provider had not consistently followed the principles of the Mental Capacity Act, 2005 (MCA) in planning and delivering people's support. People's capacity to agree to their care and support had not been fully considered to ensure that any decisions were made lawfully and in people's best interests. The registered manager undertook to address this shortfall following our inspection. People's consent was obtained before they were supported where they were able to do this.

People were protected from the risk of harm. Staff had been trained in safeguarding people and understood how to assess, monitor and manage their safety. A range of risk assessments were completed and preventative action was taken to reduce the risk of harm to people.

People were supported with their medicines in a safe way. People’s nutritional needs were met and they were supported with their health care needs when required. The service worked with other organisations to ensure that people received coordinated care and support.

People were protected by safe recruitment procedures to help ensure staff were suitable to work in care services. There were enough staff to meet people's needs. Staff received training for their role and ongoing support to work effectively.

People were involved in their care as far as possible and people were encouraged to remain independent. Care plans were regularly reviewed and updated as people’s needs had changed. Staff were provided with clear guidance to follow in the care plan which included information about people’s preferences, daily routines and diverse cultural needs. Staff had a good understanding of people's needs and preferences and worked flexibly to ensure they were responsive.

People and their relatives were happy with staff who provided their personal care and had developed positive trusting relationships. The service worked towards people having consistent support staff to ensure they felt comfortable and safe.

People, relatives and staff were encouraged to provide feedback about the service which was used to assess the quality of the service and to make any required improvements. The provider had a process in place which ensured people could raise any complaints or concerns and people felt comfortable to do this should they need to.

The registered manager and provider were aware of their legal responsibilities and provided leadership and supported staff and people who used the service. The registered manager and staff team were committed to the provider’s vision and values of providing good quality, person centred care.

The provider’s quality assurance system to monitor and assess the quality of the service was used effectively to improve the service. People's health and well-being was continuously monitored at the service.

Incidents which took place at the service were appropriately acted on and the relevant agencies notified as required. However, improvements were needed in relation to how incidents were monitored.

The inspection took place on 28 January and 1 February 2016 and was announced. The provider was given 48 hours’ notice of the inspection because the location provides a domiciliary care service. We needed to be sure that the registered manager would be available to speak with us.

The service provided personal care to adults with a variety of needs living in their own homes. This included people living with dementia, physical disabilities, older people, people with learning disabilities and younger adults. At the time of inspection there were 90 people using the service.

The service 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.

People told us that they felt safe when staff supported them.

People told us that staff arrived on time for appointments to support them. We saw that there was a system in place that monitored the time staff arrived and left each appointment.

People were supported to take their medicines by care workers who had received training in medicines management.

When people started to use the service a care plan was developed that included information about their support needs, likes, dislikes and preferences. This meant that staff had the relevant information to meet people’s needs.

Risk assessments were in place which set out how to support people in a safe manner. The service had safeguarding and whistleblowing procedures in place. Staff were aware of their responsibilities in these areas.

People were supported to maintain a balanced diet where they were supported with eating and drinking. People were supported to access healthcare services.

Care workers were supported through training and supervision to be able to meet the care needs of people they supported. They undertook an induction programme when they started work at the service.

Staff told us that sought people’s consent prior to providing their care.

Staff developed caring relationships with people and understood people’s needs and preferences.

People were involved in decisions about their support. They told us that staff treated them with respect.

People were involved in the assessment and review of their needs.

People and staff felt the service was well managed. The service was well organised and led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009.

The provider carried out monitoring of the quality of the service.

During this inspection we saw an amended policy for annual appraisal and development. The policy outlined that supervision sessions should take place on a bi monthly basis and every member of staff should receive an annual appraisal. The policy outlined that supervision sessions could take place in the form of one to one sessions, group or team sessions.

One member of staff told us:” The care is discussed with the person and their family before I visit. We never go out on our own on the first visit we are always accompanied by the supervisor.”

We looked at five care records and found they included detailed care risk assessments and plans for managing the identified risks. The care records were reviewed four to six weeks following commencement of care and support and from then on a three, six and twelve monthly basis.

We saw in the care records we reviewed that when a new piece of equipment was introduced to the home or a pre – assessment of needs was carried out all equipment was risk assessed and the manager explained the supervisor ensured equipment was safe and in good working order at each care plan review.

We looked at three staff files and found documented evidence that supervisions had taken place. The provider was unable to demonstrate that supervision and appraisals were carried out in line with the standard documented in the provider's policy for annual appraisal and development.

The supervisor also carried out unannounced quality observational checks, where staff were observed carrying out their duties, people’s views were sought and paperwork monitored. The staff we spoke with told us that they found the spot checks very useful and one member of staff told us:” We are given constructive criticism at the spot checks. This helps us to reflect and make improvements”.

As part of our inspection on this service we spoke to two people using the service, four members of staff working at the service, and two relatives of people using the service.

The people we spoke to who used the service were very complimentary about the quality of care which was delivered to them. The people who used the service told us that the carers who came into their home were well trained and competent in carrying out their roles. All of the people we spoke to described a very caring and efficient service.

One person we spoke to said the service was, “Excellent”. They went on to comment that, “They bend over backwards to meet our needs.” Another person who used the service told us, “The carers are brilliant. I have no complaints whatsoever with the girls.” This person went on to say that, “I am the happiest lady receiving care.”

We spoke to the staff working at the service who told us they were happy in their roles and that they felt supported by the management of the service. They described knowing the people who used the service well. Staff described having plenty of time to spend with the people using the service. They told us they had adequate time between visits and that they enjoyed visiting people who used the service, who they got to know personally. One member of staff told us, "I love it. I’m quite happy in my job. The office is always there for me if I have any problems.” Another member of staff commented that, “You can see that the client is in a routine and that they know who is coming in to see them.”

The relatives we spoke to were also very positive about the quality of care being delivered and about the way in which the carers interacted with the person being cared for. One relative told us that, “They will match the carers up to the needs of the client.” Another relative commented, “I have no problems with the service at all. I couldn’t ask for better really. They are very good.”