Netherclay Home Care is a Home Care Agency that provides personal care to people living in the Taunton area. At the time of this inspection, they were providing personal care for 135 people. They also provided a domestic service to people in their own homes.

At our last inspection, we rated the service good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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At this inspection we found the service remained Good

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.

People told us they felt safe. Staff understood how to recognise and report signs of abuse or mistreatment. Staff had received training on how to recognise the various forms of abuse, which was regularly updated and refreshed. The provider carried out risk assessments to identify any risks to people using the service and to the staff supporting them. There was a lone working policy, which staff knew about. Safe recruitment processes were completed.

The provider had recognised the need to recruit sufficient numbers of staff to keep people safe. There was a stable staff team, which provided people with continuity of care. The rota recorded details of people’s visit times and which staff would provide the visit. The registered manager or senior staff were on call outside of office hours and had access to the rota, telephone numbers of people using the service and staff with them.

Staff supported people safely with their medicines if required. Staff followed good infection control practice. Staff knew the reporting process for any accidents or incidents. Records showed that the provider had taken appropriate action where necessary, and made changes to reduce the risk of a re-occurrence of an incident. The service had suitable processes to assess people’s needs and choices, the care lead went out to assess people prior to a package of care commencing to check the service could meet the person’s needs.

Staff had appropriate skills, knowledge, and experience to deliver effective care and support. All new staff completed the Care Certificate. The Care Certificate is an identified set of national standards that health and social care workers should follow when they are new to working in the care sector. Records showed staff received comprehensive training, which enabled them to carry out their roles effectively. Staff received regular support and an annual appraisal from the registered manager and team leaders. Staff completed food hygiene training, they knew about good practice when it came to nutrition and hydration.

Staff asked people for their consent before delivering care or support and they respected people’s choice to refuse care. Care records showed that people signed a contract of care where they gave their consent to the care and support provided. All the people we spoke with said they had been included from the beginning in planning their care.

The provider was responsive to people’s needs. Staff supported people, and involved them, (as far as they were able), to draw up and agree their own support plan. All the relatives we spoke with said they had good communication with most staff at every level and were involved in their relative’s care.

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

This inspection took place on 03 and 04 December 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available for the inspection. It also allowed us to arrange to visit people receiving a service in their own homes.

Netherclay Home Care provides personal care to people living in the Taunton area. At the time of this inspection they were providing personal care for 138 people. They also provided a domestic service to people in their own homes.

The last inspection of the agency was carried out on 22 May 2013. No concerns were identified with the care being provided to people at that inspection.

There is 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.

People who received personal care from Netherclay Home Care told us they were happy with the care and support provided. They told us they were supported by caring friendly staff who understood their personal needs and preferences. Some people said they found the consistency of regular care workers was not good. The registered manager had identified this as an area requiring improvement and had put a new system in place ensuring stable teams in each area covered. One person said, “I have had different carers coming, but it has improved lately.” Another person said, “I see my regular carers and I am more than happy.”

People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. People told us staff knew them and how they liked to be looked after. The registered manager confirmed they would only take new people on if they could meet their needs. If they were unable to meet their needs they would signpost them to another agency or health care professionals.

People told us they thought staff had been trained appropriately to meet their needs. Care workers had access to training specific to their roles and the needs of people. For example they received training on managing a new hoist in one person’s home. And had clear guidance and training on how to communicate effectively with one person. They understood people’s needs and were able to explain to us how they would care for each person they visited.

Care plans included clear guidance for staff, to enable them to deliver consistent care the way people preferred. Care plans had been reviewed regularly with people and changes made when needs had changed. People confirmed they discussed their care plans with staff and had signed consent forms. People said staff always sought their consent before providing care and support. One person said, “They always ask me before they do anything.”

People were protected from abuse because the provider had systems in place to ensure checks of new staffs characters and suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse. People said they felt safe when being cared for; we observed people were happy and relaxed with staff during our home visits.

Most people were able to access health care professionals independently but assistance could be provided if requested. Staff monitored people’s health with their consent and could direct to healthcare professionals as appropriate.

The agency had a complaints policy and procedure that was included in people’s care plans in large print. People said they were aware of the procedure and had numbers they could ring. People and staff spoken with said they felt confident they could raise concerns with the manager and senior staff. Records showed the agency responded to concerns

We visited the registered services office and looked at fourteen care records, the employment records relating to four staff and documents relating to the administration and management of the service. We spoke with seven staff and a representative of the provider.

Following the inspection visit we spoke with four people who used the service. We also reviewed information sent to us from the service in regard to the training of staff and the quality assurance processes carried out by the provider.

People told us about their experiences of support from the service. Comments included, “Excellent. Looked after alright.” And “I am quite happy.”

We saw that people’s health, safety and welfare was protected when more than one provider was involved in their care and treatment. This was because the service worked in co-operation with other providers such as the Independent Living Service from the NHS and local social services partnership.

When we spoke with people about the staff who provided support to them they told us, “All pleasant.” And “Good, staff have got to know me.” One person thought, “Some staff showed a lack of experience but some good care workers have visited.”

The provider had an effective system to regularly assess and monitor the quality of service and put actions in place to improve the service in the best interests of the people who used it.

This inspection was carried out to check compliance because of concerns found at the last inspection visit in February 2012. One compliance action was made about assessing and monitoring the quality of the service provision. One improvement action was made about care and welfare of people using the service. At this visit we found that both areas were compliant. We visited the service office where we reviewed records and spoke with eight staff including the registered manager. We contacted people who used the service or their relatives following the visit.

We were told that Netherclay Home Care was participating in a multidisciplinary rehabilitation scheme. This was working with health and social work teams to enable people to regain skills to care for themselves. The service also provided support to a small number of children.

People told us that they discussed the support they needed and had given consent to their plan of care. Additional comments were “They do exactly what I ask of them” and “they regularly come out to discuss my care plan.” People made positive comments about the care which included, “found the service worked perfectly and really very good.” People told us they had appreciated the extra support they had to maintain social contact, such as helping them to go out. They also told us, “excellent – they really have got to know me,” and “thrilled and delighted” about the quality of the service given.

People that used Netherclay Homecare told us the agency had involved them in aspects of their care and support. Most people knew that they had a care plan which had been discussed with them. They told us they had information about the agency and knew how to contact them, raise concerns and find out information.

We spoke with people who received a variety of care visits ranging from twice a week to four times a day. Every one said something positive about the care that they had received. People who spoke with us were satisfied with the actual care when staff arrived at their home. Most people found it to be “pretty good.”

While people were satisfied with their care there were some concerns about the way in which it was organised and delivered in order to meet their needs. The agency has 230 clients. Of the 17 people we spoke with seven people had concerns about the number of carers who attended them or their relative. Some people felt that this affected the way they were able to live their lives.

Five people told us that they had problems with carers arriving too late or too early and that this had affected their lives.

People told us they felt safe with the care they received. They said they felt the staff members were trustworthy and well trained.

People that used services from the agency told us they felt the staff members were well trained and competent. One person said “They are very good. They give me a good service. They give me the care I need. We heard that staff knew what they were doing. “They are trained very well. One came with a person who was shadowing. I would say 90% are very good indeed. You can’t complain.”

When people had regular carers they praised them. “They are always polite and very caring. My regular carer will always do that bit extra. She really helped me recently when my back went. She helped as much as she could.”