Network Health and Social Care Dursley branch (part of the Network Healthcare Professionals Limited group) is a domiciliary care agency that provides care and support to people in their own homes. It provides a service to older adults and younger disabled adults. At the time of the inspection the service provided care and support for 150 people.

At our last inspection in October 2015 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 ongoing 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.

At this inspection we found the service remained Good.

People were supported to maintain good health and be involved in decisions about their health. They were provided with personalised care and support. Staff had the knowledge and skills to carry out their roles and their training was updated annually. People were positive about the care they received.

Risks to people’s and staff safety were identified, assessed and appropriate action was taken. Staff had completed safeguarding adults training and knew how to keep people safe and report concerns. People’s medicines were safely managed. There were thorough recruitment checks completed to help ensure suitable staff were employed to care and support people.

People were encouraged to make choices about their care and support and to be as independent as possible. People were protected by staff having regard to the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework to assess people’s capacity to make certain decisions.

Quality assurance procedures were used to monitor and improve the service for people and included them in developing their care and support. Feedback from people and their relatives or supporters was used to improve the service when their views were sought annually. Monitoring and auditing of systems had ensured action was taken when required. Regular staff and management meetings ensured concerns were discussed and changes were implemented when required.

Further information is in the detailed findings below.

The purpose of this inspection was to find out is the service safe? We completed an inspection on 27 and 28 February 2014 and we told the provider to take action. Below is a summary of what we found. The summary is based on looking at records and talking to staff during the inspection.

If you want to see the evidence supporting our summary please read the full report.

We used the information we collected during this inspection, to answer one of the five questions which now form the basis of our inspections. Is the service safe?

Is the service safe?

We found that detailed 'medication risk assessments' were completed and the level of support people required was recorded. People had signed a consent form for care staff to administer their medicines. Medicine care plans provided additional information about how people liked to take their medicines. Regular monthly medicine audits were completed at the agency office when records were returned. In depth medicine audits were completed by the quality and risk assessment staff in people's homes annually.

Medicine administration had improved and people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. Recently 13 of the 45 care staff had completed medicine training and a further ten staff had planned medicine training on 30 September 2014. The agency planned that all staff would update their medication training annually. The training information was clear about what 'prompting' and 'assisting' people with medicines meant. The agency kept an electronic record of when staff required training updates. The agency had a detailed medicines policy for care workers to refer to.

We spoke with two people who used the service. We found that they were involved in making decisions about the care and support they received. They told us "staff are very good and respectful" and "I am involved in my care and there is a flexible approach in supporting me". They also told us that "they have never not turned up" and "fine with the way things are going, wouldn't change the girls".

We spoke with three relatives of people who used the service. We were told "the girls are very efficient at doing their job, timekeeping is good and they go out of their way" and "smashing girls".

We found care documentation had been developed to direct staff about how people should be supported with their assessed needs. This included appropriate individual information about the delivery of people's care that had been regularly been reviewed.

Staff we spoke with were knowledgeable about the needs of the people they supported. They demonstrated they knew what action they would take if they saw or suspected any abuse.

Appropriate recruitment checks were undertaken before staff began working for Network Health and Social Care. Staff had received appropriate training and supervision to support them in their role.

The systems in place to evaluate practices included the views of the people who used the agency so that their comments could help to improve and develop the service.

Network Health and Social Care Dursley branch (part of the Network Healthcare Professionals Limited group) is a domiciliary care agency that provides care and support to people in their own homes.

We gave the provider 48 hours’ notice of the inspection. We did this to ensure staff would be available at the service. At the time of the inspection the service was providing personal care to 136 people.

There was no registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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 previous registered manager had left the agency on 22 May 2015. The provider had put in place an acting manager, who we were told would be applying to CQC to register as the manager.

People received care and support from staff they felt safe with. People were safe because staff understood their role and responsibilities to keep people safe from harm. Staff knew how to raise any safeguarding concerns. Risks were assessed and individual plans put in plans to protect people from harm. There were enough skilled and experienced staff to meet people’s needs. The provider carried out pre-employment checks on staff before they worked with people to assess their suitability.

The service was effective because staff had been trained to meet people’s needs. Staff received supervision and appraisal aimed at improving the care and support they provided. People were supported to maintain their independence. Staff understood their roles and responsibilities in supporting people to make their own choices and decisions.

People received a caring and compassionate service. They were treated with dignity and respect. People were involved in planning the care and support they received. Staff protected people’s confidentiality and need for privacy.

The service was not consistently responsive to people’s needs. English was not the first language for one person using the service and the provider had not considered how they were going to communicate with them. Another person’s care records contained inaccurate information concerning their preferred name. Staff providing care and support were familiar to people and knew them well. The provider encouraged people to provide feedback on the service received. The service made changes in response to people’s views and opinions.

People received a service that was well-led because the manager and other senior staff provided good leadership and management. The vision and values of the service were clearly communicated and understood by staff. Staff understood their roles and responsibilities. The quality of service people received was regularly monitored and any areas needing improvement identified and addressed.