One to One Homecare Limited – Head Office provides personal care and support to people living in their own homes. When we inspected on 26 October 2016 there were 126 people using the service. This was an announced inspection. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to know that someone would be available.

A registered manager was 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 we spoke with and their relatives were complimentary about the care provided. They told us they received safe and effective care by care workers who were kind and compassionate.

Systems were in place which provided guidance for care workers on how to safeguard the people who used the service from the potential risk of abuse. Care workers understood their roles and responsibilities in keeping people safe and actions were taken when they were concerned about people’s safety.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

There were sufficient numbers of care workers who had been recruited safely and who had the skills and knowledge to provide care and support to people in the way they preferred. Care workers had developed positive relationships with people who used the service and understood the need to obtain consent when providing care.

People received care and support which was planned and delivered to meet their specific needs. People and/or their representatives, where appropriate, were involved in making decisions about their care and support arrangements.

Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment. Where required people were safely supported with their dietary needs

There was a complaints procedure in place and people knew how to voice their concerns if they were unhappy with the care they received. People’s feedback was valued and used to improve the service.

There was an open and inclusive culture within the service. Staff spoke warmly of the management team including the directors of the agency and told us they felt supported in their roles. Office staff and care workers understood their roles and responsibilities in providing safe and good quality care to people. An effective quality assurance system was in place and as a result the service continued to develop.

We spoke with 11 people who used the service and three people’s relatives. They told us that they were happy with the service that they were provided with and that the support they received met their needs. One person said, “Absolutely brilliant, so pleased we used it, very good.” Another person told us, “I am quite happy.” Another said, “Okay as far as I am concerned.” One relative told us, “We have no problems at all, very good service, (person) is happy.”

People told us that the care workers were polite and treated them with respect. One person told us, “Oh always.” Another person told us, “They (care workers) had better be, I would never let my own children be horrible to me, so I wouldn’t allow others to be.”

We looked at the care records of five people who used the service and found that the people experienced care, treatment and support that met their needs and protected their rights.

We found that there were enough care workers employed to meet people’s needs. One person told us, “Everyone one I have come here (person’s home) are very good and they are lovely to me.”

The provider monitored the service to ensure that people were provided with safe care and support which included announced and unannounced checks on the quality of care and support people were receiving during their care visits. One person told us, “(Senior staff member) was only here the other day checking paperwork and things.”

People told us if they had any concerns that they would speak to their care worker or contact the office. One person told us when they had first started using the service they had been told, “Phone the office if you are not getting the right service…but we have had no problems.”

We spoke with four people who use the service and four members of staff . We also spoke with two relatives of people who use the service and examined the content and results of a relatives questionnaire. We examined policies and records relating to the outcome areas inspected.

People who used the service were happy with the quality of care and the way it was delivered. One person said, "they are all first class. They do my personal care and spend time talking to me as well."

We tracked the care records of four people who used the service and found that they experienced care, treatment and support that met their needs and protected their rights. We saw evidence that care planning was used safely through clear assessments and plans to meet assessed needs.

People who use the service were protected from the risk of abuse. Staff were trained to understand the signs and symptoms of abuse and had clear guidance on how to respond to concerns or allegations of a safeguarding nature.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We saw staff records which demonstrated that staff received a wide range of training opportunities in all areas related to the needs of people who use the service.

The provider had an effective system to regularly assess and monitor the quality of service that people receive, including regular audits and monthly reporting.