This inspection took place on 11 October 2017. We gave the provider four days’ notice as the service provided support to people in their own homes and we needed to make sure the provider was available to assist with the inspection.

The last comprehensive inspection of the service was on 04 November 2015 when we rated the service as Good for each of the five questions we ask.

Night and Day Care provides care and support to people living in their own homes. At the time of this inspection, 15 people were using the service.

The provider’s Nominated Individual is also the 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 2008 and associated Regulations about how the service is run.

People told us they felt safe with their care workers. The provider had systems to keep people safe and care workers followed these. They followed effective recruitment procedures to make sure care workers were suitable to work with people using the service and there were sufficient numbers of care workers to provide the care and support people needed.

Where people needed support with their medicines, care workers provided this safely.

The provider worked within the principles of the Mental Capacity Act 2005 (MCA) to make sure that, as far as possible, people made decisions about the care and support they received.

People using the service were cared for by staff who had been appropriately trained and supported.

Care workers gave people the support they needed with their nutritional needs and the provider supported people using the service to meet their health care needs.

People using the service told us they liked their regular care workers and described them as kind, caring and professional. People told us they were supported to do things for themselves when they were able.

The provider recorded people's religious, cultural and communication needs and their care workers were able to tell us about these.

The provider had a complaints policy and procedure in place. People using the service told us they knew how to complain to the provider but they told us this had never been necessary. People using the service were also able to provide feedback on the care they received.

People told us their care workers usually arrived on time, stayed the correct amount of time and completed all of the tasks that were included in their care plan.

The registered manager was professionally qualified. People using the service and care workers told us the manager was approachable and supportive. The provider had systems to monitor the quality of the service that people received and to make improvements. There was an open culture at the service. People using the service, their relatives and care workers told us they felt able to approach the management team and felt valued by them. The provider actively engaged with our inspection and they provided the information we needed to make our judgements.

This inspection took place on 04 November 2015. The inspection was announced. We gave the provider 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure the provider was available to assist with the inspection.

The last inspection of the service was in August 2013 when we found the provider was compliant with all of the outcomes we checked.

Night and Day Care provides care and support to people living in their own homes. When we inspected, the service was supporting 36, mainly older, people.

There is a registered manager for 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 provider assessed risks to people using the service and took action to mitigate these. The provider carried out checks before care workers started to work with people using the service. When people needed support with their medicines, care workers provided this safely.

Care workers received the training they needed to work with people using the service. The registered manager was aware of their responsibilities under the Act and ensured all care workers completed appropriate training. People’s care records included assessments of their healthcare needs and details of how care workers would ensure they met these.

People using the service and their relatives commented very positively about the care they received and told us their care workers were kind, respectful and caring. Care workers treated people with dignity and respect.

People using the service told us they received care and support that was personalised to their needs. People using the service and their relatives told us they did not have any complaints about the care and support they received.

People using the service, their relatives and staff working for the service were very complimentary about the manager and the service. The provider kept information about people using the service confidential. The provider had systems to assess and monitor the quality of the service.

We spoke with 6 people using the service or their representatives, 5 care workers and the agency’s registered provider / manager. People told us they were happy with the care and support they received. Their comments included “they are excellent, everything is done to a very high standard” and “the carers are all excellent.”

We looked at the care plans for 4 people using the service. We saw the care plans detailed people’s health, social and personal care needs and the support their care workers should provide. The plans were updated regularly and people were involved in reviewing the care they received.

The provider had policies and procedures for safeguarding people using the service. Care workers understood the procedures and were trained to identify possible abuse. A relative told us “I know my [relative] is safe with her carers, it takes a lot of worry off me.”

We looked at the training and supervision records for 4 care workers and saw that staff received regular supervision and training that was regularly updated. One care worker told us “I only started recently but I’ve done a lot of training.” This meant that care staff had the support and training they needed to look after people.

There were procedures in place to monitor the quality of services provided. The provider carried out regular audits and people using the service were asked for their views on the care and support they received.

We spoke with eight people who used the service, or their relatives, and three care workers. People using the service told us that they felt safe with their care staff and they were given the care and support they needed.

People’s comments included “they are excellent, we’re most satisfied,” “my carer is first class, always helpful” and “the carers are always punctual or they ring if there’s a problem and they’re held up.”

The care needs of people using the service were well assessed and clearly recorded in their care plans. Risk assessments were completed to make sure that people were cared for safely. The agency has thorough recruitment policies and procedures to make sure that all required pre-employment checks are carried out. This meant that people using the service were cared for and supported by suitable staff.

Care staff told us that they felt well supported by the provider and they were able to access the training they needed to do their job. Care workers' comments included “every week I go to a course, for example I’ve done effective communication, mental capacity and safeguarding,” “I feel fully supported by the company” and “I like working here, “we get lots of feedback.”