We inspected this service on 6 December 2016 and the inspection was announced. We gave the provider four days’ notice of the inspection so that we could arrange to visit some people who used the service and speak with staff. They were last inspected on 6 December 2013 and were fully compliant against the standards we reviewed.

J and R Care is based in Long Eaton and provides care and support to adults in the local area. There was a registered manager at the service. 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. There were 2 people using the service at the time of our inspection and the majority of the care was being provided by the registered manager with the assistance of one additional relief member of staff.

People decided on the care they wished to receive. They consented to their care and arranged for it to be amended if their needs changed. Their privacy and dignity was respected and upheld by the staff who supported them.

Risk was assessed and plans were in place to monitor people’s health and to assist them in a safe manner. They described how to support people safely, including using equipment to assist them to move. Some people received assistance to take medicines and records were kept to ensure that this was done safely. When they required assistance to eat and drink the provider ensured that this was planned to meet their preferences

Staff had caring relationships with the people they supported and encouraged them to raise any concerns that they had; and there was a complaints procedure in place but people said that they had not needed to use it.

Staff were supported and trained to ensure that they had the skills to support people effectively. There were safe recruitment procedures in place to ensure that they were safe to work with people. They were trained in safeguarding and understood how to protect people from harm. Staff were confident that any concerns would be reported and investigated.

There were enough staff to meet people’s needs and the balance was continually reviewed as the provider intended to recruit more staff and develop the service. There were systems in place to monitor and drive improvement.

We spoke with two relatives and two people using the service. One relative said, “I have found the care provided to my parent to be good and given with kindness. Staff were very clear about their roles and were flexible in their approach. They were really helpful to us as a family by being there with my parent. They listened to my parents’ concerns. They were able to cope with the changes that occurred over time”.

Discussions with the registered manager and people using the service demonstrated that the agency worked well with other services to ensure all needs were met. We found improvements had been made to the recruitment process to ensure people using the service were safe. People told us the agency was flexible and made every effort to meet their needs.

People that we spoke with were very positive about the quality of support that was provided to them. From discussions with all four people it was clear that the care workers provided support that was individualised to meet either their needs or those of their relatives. One relative told us that this support provided them with some respite as they felt comfortable leaving their family member alone with care workers.

We spoke with one person who used the service and two relatives. Everyone told us they were happy with the care and support provided by the service. One person told us their main carer was "kind and caring, and they could have a laugh and a joke.” One relative described that service as “brilliant” and they felt confident in the ability of care workers. Both relatives told us the service was flexible and able to adapt to changing situations.

People told us they felt involved in their care and were aware of their care plan. They told us care workers arrived on time and stayed for the full agreed amount to time. One relative told us that they felt that staff listened to them when they made suggestions about how the care was delivered. Everyone spoken with know how to raise any concerns, but had not needed to.

We saw that procedures were in place to protect people. Training was being arranged for staff on the protection of vulnerable adults. We found that the recruitment of staff was not effective. Police checks had been completed to ensure staff were suitable to work with vulnerable adults. However, other required information such as employment history and evidence of conduct in previous employment had not been obtained and kept on file.