This announced comprehensive inspection took place on 29 and 30 August 2018. Telephone interviews with people who used the service, their relatives and care staff were completed on 13 and 14 September 2018.

Jewel Home Support is a domiciliary care agency. They provide personal care to people living in their own homes in the community for; older adults, including people with dementia, people with physical disabilities, people with learning disabilities and people with autism. At the time of our inspection there were 140 people receiving a regulated activity from this service. The number of people receiving a regulated activity had increased from 40 since our last inspection.

At our last inspection, published in April 2016, we rated the service as good. At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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 registered manager was supported by a team of managers and senior staff which included a compliance manager, training manager and care coordinators, who planned and arranged visits and managed the staff rotas.

The service continued to meet people's needs safely. Staff were knowledgeable about how to protect people from the risk of harm and abuse and how to raise any safeguarding concerns. Risk assessments had been completed in people's care plans and had been reviewed and updated regularly. Staff had signed the risk assessments to indicate they had read them.

The service had sufficient staff to support people safely. Staff we spoke with confirmed this. Medicines continued to be managed safely and records were maintained properly. Staff had received training in infection control and could describe the steps they took to minimise the risks of infection.

Accidents and incidents had been recorded and actions taken to ensure the risk of reoccurrence was managed.

People's needs continued to be assessed prior to their care package starting. Some people received fast track care which had been commissioned by health providers. There was an effective system in place to ensure enough information about people's needs had been captured. There was evidence of the service working with other organisations and families to ensure people's needs were assessed consistently and support provided to achieve optimum outcomes.

Staff received induction training and ongoing training to ensure they had the skills and knowledge they needed to support people. Staff commented on the quality of the training. People we spoke with, who used the service, said they felt the staff were knowledgeable.

The service continued to work within the principles of the Mental Capacity Act 2005 (MCA). People's capacity to make specific decisions had been assessed. Staff understood the importance of ensuring people consented to care and support provided. At the time of this inspection no one was subject to restrictive practices amounting to a deprivation of liberty.

People were supported with meal preparation and to maintain their nutrition and hydration. Records of food and drink prepared and consumed had been completed.

People had access to health services, with support when required. Some people had equipment in their homes to support them with the activities of daily living, and mobility. There was information about how this was to be used for support staff. Staff received practical training on the use of hoists and other mobility aids, prior to supporting people with this.

Staff understood the importance of getting

This inspection took place on 25 and 26 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 someone would be in to facilitate the inspection. The service had not been previously inspected since registering with the Care Quality Commission.

Without exception, people we spoke with told us they felt safe using the service.

The service had appropriate systems and procedures in place which sought to protect people who used the service from abuse.

The service had a whistleblowing policy in place and this told staff what action to take if they had any concerns.

We found the care and support records of people who used the service were comprehensive, well organised and easy to follow and included range of risk assessments to keep people safe from harm.

We found there were robust recruitment procedures in place and required checks were undertaken before staff began to work for the service.

We looked at how the service managed people’s medicines and found that suitable arrangements were in place to ensure that people who used the service were safe. We looked at the medicines administration record (MAR) charts for people when we visited them in their own homes and found that these had all been completed correctly and were up to date.

There was an appropriate up to date accident and incident policy and procedure in place and details of any accidents and incidents were recorded appropriately.

There was an up to date business continuity plan in use which covered areas such as loss of utility supplies, loss of staff, loss of IT systems and adverse weather.

People who used the service told us they felt that staff had the right skills and training to do their job. New staff were given an employee handbook at the start of their employment which identified the principles and values underpinning the service. There was an ‘induction and job start checklist’ in place which was used to audit the progress of new staff relative to the induction process.

Staff were given a copy of the organisation’s policies and procedures which were available electronically or in paper format and staff knowledge of these policies and procedures was tested out at supervision meetings and as part of the process of induction.

Staff told us they felt they had received sufficient training to undertake their role competently showed staff had completed training in a range of areas, including dementia, safeguarding, first aid, medicines, the Mental Capacity Act 2005, infection control and health and safety.

Staff received supervision and appraisal from their manager and the service which kept a record of all staff supervisions that had previously taken place.

The service used an electronic staff scheduling and monitoring system which enabled real-time live updates to be sent to care staff members which reduced the potential for missed or late visits.

Before any care and support was given the service obtained consent from the person who used the service or their representative.

We found that each person who used the service had a comprehensive Health Assessment which was easily accessible within their individual care and support plan.

People who used the service and their relatives told us that staff were kind and treated them with dignity and respect.

Support planning documentation used by the service enabled staff to capture information to ensure people from different cultural groups received the appropriate help and support they needed to lead fulfilling lives and meet their individual and cultural needs.

People’s care and support plans contained a ‘service user compatibility assessment’ which recorded each person’s preferences for the staff who supported them. This was matched with available staff members who were then introduced to the person prior to any service being delivered.

People who used the service had a care p