Independent home living (Beverley) is a domiciliary service providing personal care to people living within their own houses and flats.

At our last inspection we rated the service as 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.

Systems and processes were in place to support people to stay safe. Staff were trained in safeguarding and knew how to recognise and report abuse. Medications were managed in line with company policy. The service provided information to people to support them to remain safe within their homes.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff received a thorough induction which included classroom training, shadowing shifts and competency checks. Staff understood the importance of promoting independence to maintain people’s wellbeing.

Staff were observed to be kind and caring. Staff understood what was important to people; this was evident throughout the inspection. Staff spent time with people during calls and had meaningful conversations with them; staff treated people with dignity and respect. Care plans were detailed and clearly informed staff of the support people required.

People told us the service was responsive to their changing needs. People and their relatives knew how to raise concerns and were confident these would be dealt with in the appropriate way. We found staffing levels were appropriate to meet people’s needs.

Care plans held information of people’s wishes for end of life care. Detailed records instructed staff on how to support people in a dignified way, in line with their wishes.

People were confident the service was managed well. There was a clear management structure and staff spoke positively about the management team. The registered manager informed us they were currently recruiting a member of staff to focus on quality assurance and auditing . Feedback was sought from staff, people and their relatives to continuously monitor and improve the service.

Further information is in the detailed findings below

The inspection took place on 3 March 2016. The inspection was announced. The registered provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be at the location offices when we visited.

Independent Home Living Beverley is a domiciliary care agency which is registered to provide personal care to people in their own homes. The service supports people living in Beverley and the surrounding villages and provides assistance with personal care, domestic help and companionship. At the time of our inspection the service supported approximately 100 people with approximately 70 people receiving support with a regulated activity.

The service was last inspected in April 2013 at which time it was compliant with all the regulations we assessed.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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.

We found that staff had a good knowledge of how to keep people safe from harm and there were enough staff to meet people’s needs. Staff had been employed following appropriate recruitment and selection processes.

We found that people’s needs were assessed and risk assessments put in place to keep people using the service and staff safe from avoidable harm. We found that the administration of medicines was being audited appropriately. However we found that some medications were not always accurately recorded.

People were happy with the service they received and told us that the staff usually arrived on time. They told us that they generally received support from the same member of staff or group of staff.

We saw that staff completed an induction process and they had received a wide range of training, which covered topics including safeguarding, moving and handling and infection control and also more specific training such as dementia awareness and pressure area care. Staff told us they felt well supported; they received regular supervision and attended team meetings. Staff were also encouraged to complete an NVQ Level 2 or higher.

People were supported to make decisions and choices. Staff received training on the Mental Capacity Act 2005 and were aware of the importance of using this legislation should any decisions need to be made on behalf of a person who used the service.

Some people told us they received support from staff with shopping, cooking and domestic tasks. They were involved in choosing what items they wanted staff to buy or what they wanted making and were generally satisfied with the meals prepared. People were supported to access healthcare support where necessary.

People told us that staff were caring and that their privacy and dignity was respected by the agencies staff. People told us that they received the support they required from staff and that their care packages were reviewed and updated as required.

We saw that people’s needs were assessed and care plans put in place to enable staff to provide responsive care and support. People had been involved in the planning of their care and relevant people were included in reviews.

People were supported to make choices and decisions and to feedback any concerns. There were appropriate complaints procedures in place should people need to raise any issues.

People using the service and agencies staff told us the service was well-led. We could see there were systems in place to monitor the quality of care and support provided and evidence that action was taken to address any concerns.

We spoke with the care manager and the office manager on the day of the inspection and telephoned two care workers and two people's carers the following day.

We received positive comments from the carers of people who received a service from the agency. One person said, “I cannot fault the carers” and another said, “We can choose which agency to use and we would change to another agency if we were not satisfied, but we have been”.

People told us that they received a service from a small number of care workers and did not express any concerns about inconsistency, missed calls or lateness. They said that they were consulted about the care they received and were satisfied with the support they received with the administration of medication.

Care workers told us that they received appropriate training that equipped them to carry out their role effectively.

There were quality monitoring systems in place that gave people who used the service, their carers and care workers the opportunity to express their views and affect the way in which the agency was operated. Care plans were audited and complaints were responded to appropriately. More robust recording of complaints and accidents/incidents would allow areas for improvement to be identified and acted on.