This inspection was carried out on 9 October 2018 and was announced. At their last inspection on 12 February 2016, they were found to be meeting the standards we inspected and were rated as Good. At this inspection we found that they were now rated as outstanding.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. Omer Care were providing a regulated activity to 17 people at the time of the inspection.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run. In this instance, the registered manager was also the provider.

People and their relatives spoke highly of the management team and how the service was run. Staff were extremely positive about Omer Care and the service that they were able to deliver. The ethos of the service put people at the heart of all that they did. The management team and the care staff went above and beyond what was expected to ensure that people felt valued and were well cared for.

There were systems in place to ensure the high standards were maintained and further developments strived for to continue to improve people’s lives. The service was an active part of the community. People knew how to make a complaint and were very confident that they would be responded to.

People were supported by staff who had considerable knowledge about the people they supported and knew how to recognise and report any concerns. Staff were well informed about people’s individual risks and how to mitigate them and medicines were managed safely. People were supported by enough staff who were well trained and felt exceptionally supported.

People were supported in accordance with the Mental Capacity Act principles and we found that people received support with eating and drinking appropriately. Staff went further than what was expected of them to help ensure people had eaten a meal and had enough to drink.

People told us that staff were all exceptionally kind and caring. Staff took the time to get to know people and were passionate about how they supported people. People had friendships with staff who at times popped in to people to see how they were outside of their usual visit times. People felt this improved their wellbeing. People were always involved in their care and were treated as individuals. Confidentiality was consistently promoted as was privacy and dignity.

People consistently received person centred care and support. Care plans were tailored to individual needs and preferences. People were, at times, supported at the end of their lives and this was done in a way that promoted their dignity ensured they were pain free.

We undertook an announced inspection of Omer Care on 12 February 2016. We told the provider two working days before our visit that we would be coming to ensure we could access the information we needed.

Omer Care is registered to provide personal care to people who live in their own homes. At the time of our inspection 23 people received support with personal care in their own homes.

We last inspected the service on 11 August 2014 and found the service was meeting the required standards at that time.

The service had 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.

People and their relatives felt confident that people were safe and secure when receiving care in their own homes and when they were supported to go out and about socially. Staff were knowledgeable in recognising signs of potential abuse and understood how to report concerns. Assessments were undertaken to identify any risks to people who received a service and to the staff who supported them. There were sufficient numbers of staff available to meet people’s individual support and care needs. People received appropriate support from staff to enable them to take their medicines.

People received their care and support from a staff team that had a full understanding of people’s care needs and the skills and knowledge to meet them. People who used the service were treated with kindness and respect and their privacy and dignity was respected.

People received care and support that was based on their individual needs and preferences. People’s care and support plans were amended as necessary and in consultation with them to meet their changing needs. People and their relatives felt confident to raise any concerns and were in no doubt that they would be managed appropriately.

Staff were supported by the registered manager and received the training and supervision necessary to empower them to provide safe and effective support for people. People’s views about the service provision were gathered regularly to help the registered manager assure themselves that the service they provided was safe and was meeting people’s needs.

We spoke with three people who used the service and they all told us that their consent was obtained prior to care being given. We also spoke with three staff who all told us that they request consent prior to providing any care or support. They all told us that this had been covered during a training course on person centred care.

We looked at the care plans for people who used the service and saw that they included information on the care people needed, emergency information and accurate daily logs. People who used the service and a relative of a person who used the service, were positive about the care provided. On person told us, “They are very caring.”

People were supported to access medical professionals when needed.

Staff were supported effectively and given the appropriate training for their role. We spoke with three staff members. One staff member told us, “I wish all employers were like them.”

Systems were in place for monitoring risks and the quality of service provided. The service were in the process of sending surveys to people to formally gain their views. A person who used the service told us, "It’s a very effective service.”

We looked at care plans for people who used the service and found areas that required improvement.

People's views and experiences were taken into account in the way the service was provided to them. Their privacy, dignity and independence were encouraged. One person said, “They help me with showering, they are very good and treat me with respect and I feel alright with them.” A relative said, “I have seen the staff encourage mum, they speak to her rather than ‘do to her’. This is a joy.”

People told us they were satisfied with the care and support provided by regular carers and that this consistency was important to them. One relative said, “They are the best, I would recommend them to anyone. They asked about life history, they are interested and talk about things that are relevant. They don’t forget things and make sure a favourite television programme is put on. It’s personal.”

We found that robust recruitment procedures were followed to promote the wellbeing and safety of people using the service. We also found people who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People told us they felt listened to and would be able to speak to the Registered Manager if they had any concerns.

We had previously inspected Omer Care and found that they were not meeting the regulations. We told the provider they must make improvements and they sent us a plan of action telling us what they had done to improve the service. When we returned on 11 August 2014, we found that the provider had made the changes required to comply with the regulations that we inspected against.

An inspector from the Care Quality Commission (CQC) conducted this inspection. We looked at six care records. Spoke with four people who used the service. We spoke with relatives and members of staff.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found.

Is the service safe?

People had up to date risk assessments in place which had been reviewed regularly. This ensured that they were up to date and any changes in the person’s needs had been correctly reflected in their care plans and the risk assessments. The provider had completed a client information sheet for each person that was available to staff in case of an emergency. These would be handed over to the ambulance staff or medical practitioners in the event of any emergency. The client information sheet contained key information about the person, including their current medication, emergency contact details, and any allergies. This meant that in the event of an emergency, information was appropriately shared to promote safe continuity of care.

Is the service effective?

People's needs were reviewed and assessed regularly by the provider. We were told that the care provided was 'excellent' and that the provider 'knows what they are doing' when they provided care to people. When we spoke with staff we were able to confirm that that they were aware of people’s needs and the registered manager was also in tune with the needs of people who used the service. People we spoke with also confirmed that they had 'no faults to report' about the Omer Care.

Is the service responsive?

We saw that care plans were reviewed and updated regularly with the person and/or their representative. When we spoke with people we were told that the provider was flexible with the care package and if any changes were required, they would try and accommodate the person as much as possible.

Is the service well led?

The service had a registered manager in place.

People who used the service and staff had high regard for the management team and owners of Omer Care. We were told by one person who used the service, 'If I were asked what an ideal organisation is, it would be this'. We were told that the registered manager was 'very good'. The staff members we spoke with also confirmed this and said that it was a 'good organisation' which had a good relationship with them and people who used the service.