Our inspection of Julie Blackburn Homecare Limited took place on 5 and 20 June and was announced. The service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older people, people with physical disabilities, sensory impairment and people living with dementia. At the time of our visit the service provided personal care to 29 people.

The provider was also the registered manager for the service. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

At the last inspection we rated the service as ‘Good’ and there were no breaches of relevant regulations. However, on this inspection we found three breaches of regulation. There was a lack of record keeping in relation to quality audits and the driving forward of continuous improvements. The staff team felt supported through supervisions and team meetings but these were not formally recorded or minutes taken. We also found that a failure to have protocols in place for ‘as and when required medication’ and details within people’s care plans about the medicines that they needed to receive. This is a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; Good Governance due to a lack of records.

We identified two events that should have been notified to CQC but had not been. This was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

Despite the breaches of regulation, we found there was a positive culture within the service; people were treated with dignity and respect and were supported to make their own decisions. Care plans demonstrated the basic principles of the Mental Capacity Act (MCA) 2005 and we observed this being applied in practice.

Care plans demonstrated a commitment to person centred care and risks to people were assessed and managed. Care and risk plans were reviewed and the service worked in partnership with external agencies to meet people’s needs. Staff had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

Staff had access to training and plans for future training were in place. The registered manager carried out spot checks to ensure staff were competent in their roles. The manager also worked side by side with the staff on a daily basis which enabled them to be at the forefront of the care provided to the people who used the service. Staff felt supported in their role. We made a recommendation about formal supervision and appraisals.

Recruitment processes were in place and were robust and there was sufficient staff to meet people’s needs. People confirmed they received care and support from regular staff who they knew. Staff understood what action to take to safeguard people from abuse and training about this was provided.

People’s nutritional needs were catered for and the level of support provided was dependant on people’s abilities. Staff told us how they worked alongside people to prepare their own meals where they were capable.

The registered manager recorded incidents and accidents on specific concerns forms to enable monitoring and reflection on events. There had been very few since the last inspection but all instances were reflected upon and provided examples of lessons learnt.

People were protected from the risks of cross infection because staff used personal protective equipment followed appropriate infection prevention and control best practice.

There was a complaints procedure in place which allowed people to voice their concerns if they were unhappy with the service they re

The inspection of J & J Homecare took place on 21 July 2015 and was announced. At the previous inspection on 27 August 2013 the regulations assessed were all complied with.

J & J Homecare is registered to provide domiciliary care services to people in their own homes and to people that may have memory impairment, disability or medical conditions. At the time of our visit there were 30 people receiving a service from the provider.

There was a Registered Manager in post who was also the registered provider. This person will be referred to throughout the report as the registered manager. 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.

We found that people were protected from the risks of harm or abuse because staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm. Risks had been assessed in peoples homes with controls in place to reduce the likelihood of occurrence.

We found that there were sufficient numbers of staff to meet the needs of people using the service at this inspection.

Staff had been employed following the service’s recruitment and selection policies.

Medicines were administered safely by trained staff.

Staff received a range of training opportunities and told us they were supported so they could deliver effective care; this included staff supervision.

People were protected by the use of legislation that upheld their rights and their consent to care and treatment was obtained before the staff supported them with this.

We found that people were supported with adequate nutrition and their health care was monitored.

We found that people that used the service were treated kindly by staff with whom they had good relationships.

We found that people’s privacy and dignity was upheld and their overall wellbeing was considered and addressed by staff that understood their needs and wishes.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. People who used the service received additional care and treatment from health care professionals based in the community.

There had been no formal complaints made to the service during the previous twelve months but there were systems in place to manage complaints if they were received.

Staff told us that the service was well led. We found that people that used the service experienced an open, transparent and accountable management style that ensured they were kept informed about things that affected them. However, although the registered manager had processes in place to enable people who used the service to voice their opinions and views of the service, these processes were not evaluated or actioned.

We completed an inspection of J & J Home Care - 15 Paddock Court, which involved a brief visit to the organisation/location address, two visits to people that used the service, a telephone call to a relative of a person that used the service and viewing some of the files and records the service maintained.

We saw evidence in documentation that people only received care and support after they had given their consent and people confirmed this was the case when we spoke with them.

We found that people were very satisfied with the care and support they or their relative received. We saw that care was provided in line with care and support plans. People said, “The girls are very good, they treat me well” and relatives said, “Staff are very good to X” and “We have confidence in the service, the provider and the staff”.

We found that good standards of infection control were adhered to and staff were trained in infection control and food hygiene. People told us they had confidence in staff’s ability.

We saw evidence in staff files that recruitment procedures were followed and that staff received opportunities to train and develop their skills. People told us they thought the staff were appropriately trained and skilled, as they were knowledgeable about conditions, health care and care needs.

We also saw documentary evidence that quality monitoring systems were used to effectively assess the quality of the service performance so that people received improved services whenever possible.

We spoke with two people and one relative about the care people received and especially about dignity and respect.

People told us they were very well treated by the provider and the staff and that their privacy and dignity was respected. They said the support workers were polite and helpful and that they got on well with them.

People told us they were very satisfied with the service of care provided by J & J Home Care. They said the provider and staff were excellent and met all of their needs. They told us they handled their own medication where possible and were well supported with mobility, finances and shopping. They said staff were well trained.