Mears Care - Stowmarket is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to adults. At the time of this announced inspection there were 120 people who used the service.

At the last inspection of 19 September 2016, the service was rated Good. At this inspection we found the service remained Good overall and Caring had improved to Outstanding. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a 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 21008 and associated Regulations about how the service is run. People, relative and staff described the registered manager as supportive and approachable.

People using the service and their relatives told us about the ‘outstanding care’ the service staff provided. Words used to describe the care were outstanding and it could not be better. Members of staff were described as caring and competent. People using the service and their relatives complimented the staff on their positive attitude, turning up on time through all weathers, never missing a visit and being consistent, anticipating and responding to a deterioration in the person’s health.

Staff were empathic and treated people with understanding. People’s privacy and dignity were respected. Staff encouraged people to maintain and develop their independent living skills.

People continued to be safe because the staff had received training and were aware of procedures to safeguard people from abuse and manage risks to their health. Each person had a detailed support plan and staff were aware of people’s individual needs. People usually received support from the same staff.

There were robust recruitment procedures in place. People received their medicines as prescribed and information about their medicines had been recorded and medicine audits were carried out by senior staff. There were infection control procedures in place to guide the staff in how to minimise the risks of cross infection. The manager met with senior staff at the service and their manager regularly to review the service and determine if any lessons could be learnt from events.

Staff received training and supervision to enable to them to provide the support to people with regard to their assessed needs. People gave consent to the support they received. People were given support to manage their nutrition and accessed healthcare services when required.

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 support this practice.

People continued to receive support which met their individual needs and preferences. Each person had an assessment of their needs and support plan which was updated regularly as required. Staff having recognised some people were lonely had worked to support them attend clubs set up by and supported by the service staff. People knew how to raise a complaint and were confident any concerns raised would be addressed and resolved. The service had worked with other professionals to support people at the end of their lives.

There was an open and positive culture was maintained by the service. The registered manager led and supported the staff team to focus upon person-centred support. Quality checks and audits remained in place so that issues were identified and resolutions for improvements put in place. The service operated an on-call system to support the staff providing support and also to cover any care visits that the usual member of staff was unable to attend.

This announced inspection took place on 19 and 21 September 2016 when we visited 5 people in their own homes, who received a service from the organisation, spoke with staff and inspected records. We gave the provider 48 hours’ notice of the inspection in order to ensure people we needed to speak with were available. The service provides personal support to people by arrangement in their home in the local area. We also spoke with people receiving the service by telephone on 12 and 20 October 2016. The service supports over 100 people.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Systems were in place to protect people from abuse because the staff had attended training which provided them with knowledge about safeguarding people. Staff knew how to report matters to the appropriate authorities if they suspected abuse was happening. The manager and senior staff knew how to share information with the local authority when needed.

People were supported by a sufficient number of suitably experienced staff. The manager had ensured appropriate recruitment checks were carried out on staff before they commenced working with the organisation. Staff had been recruited safely and had the skills and knowledge to provide care and support taking into account people’s preferences and choice.

The provider had systems in place so that staff were trained to administer medicines and people were supported to take their prescribed medicines safely. The service had a number of call times that were deemed as time specific. That is to say it was important staff were present at an allocated time to support people with their medicines, for example before breakfast.

Staff had received training in mental capacity assessments, best interest and were competent to work with relevant professionals. This ensured that decisions were taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Staff were aware if they had concerns about people’s capacity to make decision for themselves they were to inform their manager for guidance.

The staff responded to people’s needs in an understanding and caring manner. Positive and supportive relationships had been built up between the staff, people using the service and relatives. People were supported to make day to day decisions and were treated with dignity and respect at all times. People were given choices in their daily routines and their privacy and dignity was respected. People were supported and enabled to be as independent as possible in all aspects of their lives. The service had worked with other organisations as a result of listening to the people using the service to support the development of activities for people if they wished to join a club and the plan was for this to meet monthly.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles. Senior staff carried out spot checks on staff. This is when the senior person visits the staff member unbeknown to them to check they are on time and working to the policies and procedures of the organisation. People and family members were involved in the planning and reviewing of the support provided by the organisation on a planned basis and should the persons needs change rapidly..

People’s health needs were managed appropriately with input from relevant health care profes

We spoke with seven people who use the service. People told us that staff were always polite and respectful and they were very happy with the service. We were told the service was "Very good indeed.” One person said that having regular care staff meant they felt able to "Open up and share any concerns.” Another person said that the carer had undertaken extra errands as needed for basic foodstuffs when the person had not been able to leave the house.

We spoke with ten people face to face, twenty-one by telephone and a further thirty-one by written survey as part of this inspection. People who used the service told us they were happy with the care they received and they felt safe. The service was responsive to people as it operated a twenty-four hour support line and we saw Care Co-ordinators working to cover shifts with staff who knew the people they were asked to visit to provide care and treatment.

The service had a recruitment process in place and trained staff in safeguarding and had an induction course and refresher training in place for staff. The care plans were reviewed every six months and the service sought the person’s consent regarding their care prior to any care being delivered. There was an effective complaints process and a procedure for quality monitoring.

One person said, “The staff are welcome into my home, they care for me and they cheer me up with a smile and joke.” We found the service was meeting the personal, emotional and healthcare needs of people who used the service.