This inspection took place on 16 September 2016 and was announced.

Martlets Care is a domiciliary care agency and provides personal care and support for adults and older people living in their own home in the Brighton and Hove and Havens area. At the time of our inspection around 80 people were receiving a service. The agency is registered to provide nursing care and personal care. At the time of the inspection only personal care was being provided. The service is part of the Martlets Group of services, which supports the Martlets Hospice.

On the day of our 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. However, the registered manager was not present during the inspection. The nominated individual for the organisation was present during the office visit.

There was a clear management structure with identified leadership roles. The registered manager undertook people’s assessments and reviews and was supported by a care supervisor who undertook the staff supervision and appraisals and coordinated staff training. Both had the support of a senior care coordinator assisted in the completion of the tasks. An office manager managed the care coordinating team who worked on setting up new care packages, care matching (allocating people to care staff to provide the care call), managing the capacity to take on new care packages, and ensuring peoples care visits were covered, auditing medicines administration records and care record sheets.

People told us they felt safe in the service. People were supported by care staff who were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. Care staff had been through safe recruitment procedures. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

There was a detailed care and support plan in place for each person accompanied by supporting risk assessments. Care and support provided was personalised and based on the identified needs of each individual. People told us people always got their care visit, they were happy with the care and support provided. People were supported by kind and caring staff. People’s privacy and dignity was considered when care and support was provided. People received care from kind and caring care staff. One relative told us, “The carers do things above and beyond their expected tasks. They change my mum but also put things in the washing machine to save me a job. That is consideration.”

Consent was sought from people with regard to the care that was delivered. All staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation. Where people were unable to make decisions for themselves, staff had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.

People were supported to eat a healthy and nutritious diet. People had access to health care professionals and had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans. Medicines were managed safely and people received the support they required from care staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.

There was a compliments and detailed complaints procedure. Compliments received included, ‘You all helped make my life a lot easier. I actually got a good nights sleep and got out occasionally, to met up with friends

As part of our inspection visit we contacted people using the service and their relatives to find out their views on the care provided. We were told that the care and support was “fabulous, consistent with amazing staff”. One person told us that she received “understated, quiet and efficient care with no fuss”.

People were very complimentary about how staff cared for them and the services provided when staff came into their homes. They told us that staff treated them with dignity and respect when undertaking some very personal care.

We reviewed a variety of mechanisms that the provider used to monitor feedback from people and among the letters and cards received we found the following comments. “They are just wonderful – every single member of the team who visited was caring, compassionate and highly professional.” “I cannot comment highly enough about the home team”.

Several people told us that they had received services from other organisations prior to engaging the services of Martlets Care. They commented that Martlets Care “was getting it right” and “finally ticking all the boxes for them in providing good care”.

Our visit to Martlets Care was facilitated by the registered manager. We viewed care records and spoke with people who use the service and their relatives. People we spoke with told us they were happy with the care they received and that they had been actively involved in planning their care. One person who uses the service told us "I give them full marks. Carers are very good and attentive," another person told us "I'm very happy, I have no concerns." A relative told us "The care is excellent and the quality of carers is very good".

We saw that the service had systems in place to support the recruitment of appropriate workers and we viewed recruitment processes that ensured relevant checks were carried out prior to recruitment. We viewed the personnel files of four care workers and saw that appropriate induction and training plans were in place. Staff we spoke with told us they were happy with their work. One staff member told us "I really enjoy working for Martlets Care. They are friendly and supportive and respond to any concerns very quickly." Another staff member told us "Most of the time it's pretty good. A nice company, very professional."

We observed care being delivered by workers who understood the care needs of people requiring support in their own homes. We visited two people who use the service in their homes and we spoke with a further person by telephone. We spoke with two relatives and six care staff, including a care supervisor.