We carried out a comprehensive inspection on 19 and 20 June 2018. Homecare 4U Bristol is registered with the Care Quality Commission (CQC) to provide personal care to people living in their own homes in the Bristol area. The service is a domiciliary care agency. Not everyone using Homecare4U receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection the service provided personal care to 50 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.

At our last inspection in April 2016 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 on-going 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.

At this inspection we found the service remained Good.

Why the service is rated Good.

We received positive feedback from people who used the service and their relatives. They told us they felt safe with the care of staff who worked for Homecare4U. People told us they usually had the same staff team supporting them. This meant that staff got to know people well.

There were enough staff to make sure people received the care needed. People and relatives told us care staff were generally on time. The provider had an effective system in place to monitor staffing levels and make sure they were sufficient to provide the personal care and support people needed.

Staff received supervision and training to ensure they could meet people’s needs.

Medicines were safely managed and checks in place to identify and act on shortfalls.

Staff demonstrated a good understanding of safeguarding and whistle-blowing and knew how to report concerns.

People were helped to exercise support and control over their lives. People were supported to consent to care and make decisions. The principles of the Mental Capacity Act (MCA) 2005 had been followed.

Risk assessments and risk management plans were in place. Incidents and accidents were recorded and showed that actions were taken to minimise the risk of reoccurrence.

Staff were kind and caring. People were being treated with dignity and respect and people’s privacy was maintained.

Systems were in place for monitoring quality and safety. Where improvements were needed the provider took action to address identified shortfalls.

We undertook an announced inspection of Homecare4U - Bristol on 26 April 2016. When the service was last inspected in March 2014 there were no breaches of the legal requirements identified.

Homecare4U - Bristol provides personal care to people living in their own homes within the Bristol area. At the time of our inspection the service was providing personal care and support to 64 people.

A registered manager was in post at the time of the 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.

The provider had ensured that people felt safe and their care would be delivered as required. People spoke positively about the staff and said they were confident care would be delivered as planned. Staff had received training in how to identify and respond to suspected abuse and policies to guide staff on how to report concerns were available.

There was sufficient staff on duty to meet people’s needs and to complete the required number of scheduled care appointments. The service had systems to ensure care appointments would still be met in the event of unforeseen circumstances arising, such as staff illness. Staff felt they had time to meet people’s needs and said appointments were not rushed. Medicines were managed in a way that ensured people received them when they needed them and there were systems that monitored accidents and incidents.

The provider had ensured that an effective induction and training programme was available for staff. This supported staff to provide effective care and people commented they received a good standard of care from well trained staff. Additionally, nationally recognised training in health and social care was available to staff to enhance their knowledge. The provider supported staff through a regular supervision and appraisal programme.

People told us that staff ensured they obtained consent before any care was provided. Staff understood the principles of the Mental Capacity Act 2005 and gave examples of how they supported people with decisions about their care and daily lives. People could see healthcare professionals when required and gave examples of how staff had supported them following a medical episode or a fall.

Where possible, the provider had ensured continuity in care. This had allowed staff to build a relationship with people and their relatives. We received positive feedback from people who received care and their relatives. There was a compliments book that reflected the feedback given to us during our conversations with people. Staff had ensured they were aware of people’s individual needs and understood their preferences.

People’s care records were personalised and people were actively involved in making choices and decisions in relation to their care. The service had a system that ensured regular care reviews were completed. There were examples of how the service had been responsive to reduce the risk of harm when a risk to a person had been identified.

The provider had a complaints procedure and people were given the required information they needed on how to complain if they wished to. People told us they would feel comfortable making a complaint should this be required. Staff told us the registered manager and senior staff were responsive to requests and ideas about care planning or delivery. There were systems to seek the views of people and their relatives and the service had responded to requests within these surveys.

People and their relatives spoke positively about the management of the service. Staff felt supported by the registered manager and senior managers at the service. There were systems to obtain the views of staff and key messages were communicated to staff. Th

Previous inspections of Homecare4u’s Bristol location were undertaken when the agency had an office on Coronation Road. This inspection was the first since the agency moved offices to a new location on North Street in Bristol.

People who used the service told us that the care workers treated them with dignity and helped them to do as much as they could for themselves. People said they received the care that had been agreed and they were mostly satisfied with the visits they received. Individual plans had been produced which set out people’s care needs and how these were to be met by the care workers. People told us that the plans were “updated” and “revised”, so that they reflected their current needs.

Checks were carried out on new staff so that they were suitable to be providing care to people who used the service. The care workers undertook an induction and training programme, which helped to ensure they were competent and knew how to support people safely. People who used the service described the care workers who visited them as “lovely” and “all very good”. However we also heard that the approach of staff varied, depending for example on their level of experience.

People told us they looked forward to the care workers’ visits. They felt that the agency was meeting their needs, but also mentioned aspects of the service which affected the quality of support they received. This included changes of care workers and people not always knowing who would be visiting them to provide care. We saw that the service was gaining people’s feedback and had systems in place for monitoring and improving the quality of the service that people received.