We undertook a comprehensive inspection of this service on 17 and 18 May 2016. After this inspection we received concerns in relation to staffing levels and how people’s care was managed. As a result we undertook a focused inspection to look into those concerns on 11 July 2017. This report only covers our findings in relation to these topics.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Old Friends Care on our website at www.cqc.org.uk

The inspection took place on 11 July 2017 and was announced. We gave the provider 48 hours’ of our intention to undertake the inspection. This was because the service provides domiciliary care to people in their own homes and we needed to make sure someone would be available at the office.

Old Friends Care is a domiciliary care agency registered to provide personal care to people living in their own homes. A registered provider was in charge when we inspected the service. Registered providers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. At the time of our inspection 105 people received care and support services.

A registered provider was in charge when we inspected the service. Registered providers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People we spoke with told us they felt safe with staff supporting them. Staff were able to tell us of the needs of the people they provided care for and their roles and responsibilities in keeping people safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe.

Staff had been recruited following appropriate checks and the provider had arrangements in place to make sure that there were sufficient care staff to provide support to people. People had their individual risks assessed and had plans in place to manage them, these had been updated to reflect any changes in a person’s wellbeing. Medicines were administered by staff that had received training. The provider had procedures in place to monitor that people received their medicines to safely.

People said the service was well managed and the management team were approachable. Staff felt supported by the management team and knew what was expected of them to provide good care. The provider ensured regular checks were completed to monitor the quality of the care that people received and action had been taken where areas were identified for improvement. The provider looked for ways to continually develop and further improve the service.

People and their relative’s spoke positively about provider and the care and support they received.

This inspection was announced and took place on 17 and 18 May 2016. We gave the provider 48 hours’ of our intention to undertake the inspection. This was because the service provides domiciliary care to people in their own homes and we needed to make sure someone would be available at the office.

Old Friends Care is a domiciliary care agency registered to provide personal care to people living in their own homes. A registered provider was in charge when we inspected the service. Registered providers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. At the time of our inspection 143 people received care and support services.

People said they were safe and they were cared for by staff who had a clear understanding of the risks associated with people’s needs. Staff demonstrated knowledge of the different types of potential abuse and how they should respond. People had their individual risks assessed and had plans in place to manage them. Medicines were administered by care staff that had received training. The registered provider had procedures in place to monitor that people received their medicines to safely meet their health needs.

Care staff had been recruited following appropriate checks and the registered provider had arrangements in place to make sure that there were sufficient care staff to provide support to people in their own homes. People told us they received reliable care from a regular team of staff who understood their preferences for care and support.

People told us they were listened to and were involved in making decisions about their care. Care staff understood they could only care for and support people who consented to being cared for. People told us they were happy with the way in which care staff supported them to choose and prepare meals.

People told us they received support from caring staff and the registered provider arranged opportunities for people to meet up and socialise together. People told us that staff treated them with privacy and dignity and supported them to maintain their independence.

People were encouraged by the provider to express their views and give feedback about their care. People said staff listened to them and they felt confident they could raise any issues should the need arise and action would be taken.

Care staff felt supported by the manager and registered provider and that they were given opportunity to progress. The manager was committed to developing new initiatives to support the care provided to people.

The registered provider ensured regular checks were completed to monitor the quality of care that people received and look at where improvements could be made. They encouraged an open office where staff could ‘pop in at any time’ and staff confirmed that they could ‘count on support from the office’.

People were positive about the care and support they received and the service as a whole.

During this inspection we spoke with seven people who used the service about their experiences of the support they had received. We also spoke with seven of the care staff, the provider and the registered manager.

All the people we spoke with who used the service spoke positively about the care they received. One person told us that Old friends was: “The best agency that I have had”. All the people we spoke with told us that the care staff who supported them understood their care needs. People told us that their wishes were always listened to and we found that the provider made sure people consented to any care.

We found that the provider had taken the necessary actions to ensure that people who used the service were safeguarded against abuse.

We found that the provider had the necessary assurances and checks to make sure that staff employed had been able to carry out their job roles safely and effectively.

We saw that the provider had systems in place to monitor the quality of the service. We also saw that where required the provider took action to improve the service quality.

During this inspection we spoke with three people who used the service and two relatives about their experiences of the support they had received. We also spoke with six of the staff.

All of the people we spoke with who used the service spoke positively about the care they received. One person told us that the care was, “Marvellous, I couldn't’ wish for anything better”. A relative told us that they were, “Happy with the care they give”.

All of the people we spoke with told us that the care workers who supported them understood their care needs, treated them with dignity and respect and had the knowledge and skills to support them safely.

Staff employed at the service had access to further training and told us that they felt supported by their peers and the registered manager. One staff member said that, "Training is really good”. Another said, "Good support is always around". This meant that staff had the support and knowledge to meet the care and welfare needs of people who lived there.

We saw that the provider had systems in place to monitor and assess the quality of services being provided. Feedback was regularly sought from the people using the service, families and staff. The managers regularly observed the care staff carrying out tasks and they would also seek feedback from the people who used the service. This meant that the provider was able to review the quality of the service and to ensure appropriate care was being provided.