The inspection took place on 29 January 2016 and was announced.

The service provides personal care to people in their own home. The office is located in Bourne in Lincolnshire and they provide care to people living in the surrounding area. At the time of our inspection they were providing personal care for around 20 people.

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 and registered manager were committed to providing a high quality service to people. The work schedule ensured that care calls were appropriately spaced so that staff always arrived at people’s homes when expected and care was not rushed. Furthermore the registered manager matched people receiving care to staff to support a compatible relationship and always introduced the member of staff to the person.

Staff were supported by a flexible training programme tailored to each individual member of staff’s training needs. This ensured staff provided person centred care and that they were aware of how to support people with different conditions. Staff received supervision and appraisals to monitor their performance and spoke highly of support that was always available from the office staff, registered manager and provider.

Care staff had an in depth knowledge of people’s care needs and abilities which was supported by neat, orderly and detailed care plans and briefings from the registered manager about the individual needs of people. This ensured care staff had the knowledge to identify where people were unwell and needed extra help. The provider and registered manager had recognised the importance of family relationships and monitored the health and well-being of other people in the home. People’s medicines were safely managed with their participation.

Staff supported and encouraged people to be involved with their care and to maintain their independence wherever possible. People’s abilities to make decisions were assessed and recorded and staff supported people’s decisions while at the same time risks to people were minimised. Staff were quick to raise concerns with the office if they thought a person was at risk of harm and were confident that the office staff would take appropriate action. At the same time staff knew how to raise concerns with external agencies if needed.

Staff respected people’s privacy and understood that it was important that people trusted them. They were clear on what information could be shared with other members of the family. Staff understood what was important to people when receiving care and ensured that care was flexible to meet their needs. The provider had recognised how hard it was for people to care for a loved one and provided guidance and support to help people stay connected and enjoy their family relationships.

People were encouraged to raise complaints and concerns. The office staff ensured people knew how to complain when they rang to ensure that the care provided was meeting people’s needs. The staff, registered manager and provider all took action to resolve any issue raised and prevent reoccurrence.

The staff, registered manager and provider all took pride in the company and the quality of care they provided to people. People using the service and staff were asked about the quality of service provided and action was taken to improve the service in response to their feedback. The provider had robust systems in place to monitor the quality of service provided and took action to ensure the service provided was good. The provider had developed links with healthcare professionals and charities to ensure the care provided was up to date with the latest guidelines.

We spoke with one person who used the service and the relatives of two other people who used the service. They told us the senior staff carried out home visits and discussed their care needs with them on a regular basis.

We found there were detailed care plans in place and these had been regularly reviewed. People we spoke with said they received care from the same staff group and told us staff were very reliable and efficient. One person said, “The care is first class.”

Care workers received training on medication. We saw there was a robust system of auditing medication records once they had been returned to the office. This meant people could be assured that their medicines were being managed in a safe and appropriate way.

We found there were effective recruitment and selection processes in place. Records showed all necessary checks were completed before people started work. People who used the service were generally very complimentary about the staff. They told us the staff were friendly, caring and punctual. Comments included,”Super staff, very conscientious and kind” and “We have found the staff excellent.”

People spoken with confirmed they were asked to complete a questionnaire about the service they received. They also confirmed they were made aware of the complaints process. They told us they felt able to complain and said they would do this by contacting staff at the office or speaking to the manager.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We used postal surveys, telephone interviews and home visits to people who used the service and to their main carers (a relative or friends), to gain views about the service.

We spoke with the provider and the manager when we visited the offices of the agency. We also spoke with four care workers over the telephone.

We visited two people in their own home and spoke with them and their relatives about their experiences of the support they had received.

We sent out ten questionnaires to people who used the service and enclosed a questionnaire for their relative or friend to complete. We received five questionnaires back, three from people who used the service and two from friends or relatives.

We spoke with ten people who received a service from this agency and one relative over the telephone. Everyone spoke positively about their care workers and felt that they fully supported their care needs. Without exception, people said that all their care workers spoke with them in a calm and respectful way. One person told us, “The staff treat me with respect and deal with some sensitive care needs with great dignity and in an unhurried way.”

All of the people we spoke with told us that their care was personalised to their individual needs. People’s preferred names were used and they said that they were able to express their views in making choices about their care and support. One person told us, “The staff cannot do enough to help me, and they will stay around until I do not need help, even if their time is going over.”

All of the people we spoke with told us that the staff who supported them understood their care needs, made any necessary changes in a timely way and they had the knowledge and skills to support their needs safely. One person told us, “The staff are marvellous, and they can’t do enough to help me.”