The inspection took place on 21 November 2018 with the registered provider being given short notice of the visit to the office, in line with our current methodology for inspecting domiciliary care agencies. At our previous inspection in September 2017 the service was given an overall rating of ‘Good’.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Longfields Court’ on our website at www.cqc.org.uk’.

Since that inspection we received information that indicated the service may not be operating as expected. As a result, we brought our next planned inspection forward, so we could consider the concerns.

Longfields Court is a domiciliary care agency which provides care services, including personal care, to people with a range of disabilities who are living in their own houses and flats in the community. People who used the service and staff knew the service as Trust Home Care rather than Longfields Court, therefore the service is referred to by this name throughout this report. At the time of the inspection the service was supporting approximately 80 people who needed assistance with their personal care, such as their personal hygiene and taking medication.

The service had a registered manager in post at the time of our 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 and associated Regulations about how the service is run.

Recruitment processes helped the employer make safer recruitment decisions when employing staff. However, we found the provider’s recruitment policy had not always been entirely followed.

Medication was managed safely. However, more information was required about medicines that were only given as and when the person required them.

People we spoke with were very happy with the quality of the care the service provided and how it was run. They said care workers met their needs and delivered their care as they preferred. People told us their privacy and dignity was respected, and staff were kind, compassionate, respectful and polite.

People had been involved in assessing and planning their care. Care plans provided clear, comprehensive information and guidance to staff, which assisted them to deliver care that was specifically tailored to people’s individual needs and preferences. However, one care plan we checked had not been updated in a timely manner.

Systems in place continued to reduce the risk of abuse and to assess and monitor potential risks to individual people.

Staff had received a structured induction, essential training and regular support, to help develop their knowledge and skills, so they could effectively meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Records showed people had consented to their planned care and staff understood the importance of gaining people’s consent and acting in their best interest.

Where needed people were supported to maintain a balanced diet, and their dietary needs and choices were met.

People knew how to raise complaints and concerns. People told us they would feel comfortable raising concerns, if they had any, but said this had not been necessary.

People spoke positively about the management team. There were systems in place to monitor the quality of the service provided and highlight areas for improvement. However, these had only recently been introduced, so needed to be embedded into practice. The registered manager listened to and learnt from the feedback of others, which helped to make changes to improve the service.

Further information is in the detailed findings below.

The inspection of Longfields Court took place on 4 September 2017, this was the service’s first inspection since their registration with the Care Quality Commission in July 2016. At the time of our inspection the service was providing care and support to thirty people who were living in their own homes. People who used the service and staff knew the service as Trust Home Care rather than Longfields Court, therefore the service is referred to as Trust Home Care throughout this report.

The registered provider was also the registered manager and they were actively involved in the day to day running of 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.

The registered manager and the staff we spoke with were aware of the responsibility in keeping people safe. They knew about the different types of abuse and how to report this to their manager, or to the appropriate external organisation.

Care plans contained environment risk assessments as well as risk assessments specific to people’s individual care and support needs. Staff received training in the management of people’s medicines and care plans recorded sufficient detail to reduce the risk of staff not administering people’s medicines safely.

Safe recruitment practices were followed. Staff turned up on time and did not miss calls.

New staff completed a programme of induction and there was a system in place to ensure staff received regular training and on-going supervision. This included field based checks on their performance.

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

People received support to enable them to eat and drink.

Everyone we spoke with told us staff were caring and kind. Staff treated them with respect and took steps to maintain their privacy. Staff were able to tell us about the actions they took to maintain people’s dignity and ensure people’s private information was kept confidential.

People had a care plan in place which was person centred and provided sufficient detail to enable staff to provide the care and support required by each individual. Staff made a record of the care they provided and these records were returned to the office in a timely manner.

No formal complaints had been received by the registered manager but people we spoke with told us they were aware of how to raise a complaint if the need arose.

Each person we spoke with told us the service was well led. There were regular staff meetings held and formal feedback was gained from people who used the service through questionnaires. There were systems in place to audit care plans and related documentation although where a concern had been identified, the action taken was not recorded. We have made a recommendation about audits.