About the service:

Optimal Homecare Services is a domiciliary care agency that was providing support to 15 people at the time of the inspection. Not everyone using Optimal Homecare Services receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service:

People felt safe and were happy with care staff. Care staff knew how to recognise and report potential abuse. Risk was considered in relation to equipment, environment, and any other specific need, and supported with person focused risk assessments.

People received support from a consistent staff team who arrived on time and stayed for the required duration of the call. Recruitment checks were robust. Staff had medication training and followed the principles of good infection control.

The registered manager provided clear leadership based on reflection and of accepting nothing less than the best. Care staff received regular training and practice updates and were subject to regular competency checks. All staff told us how much they felt part of a team. All people and staff told us communication was excellent.

Staff understood the importance of obtaining consent and people told us they always had choices. People were supported with nutrition and accessing health services if needed.

People were very happy with care staff and spoke highly of them. People were properly assessed and their needs and wishes were reviewed regularly, and privacy and dignity was promoted along with independence.

The service had received no complaints but people knew who to contact and care staff felt able to raise any issues.

Optimal Homecare Services had a strong focus on the best outcomes for both people and staff. The values of the registered manager showed high expectations and the views of all were considered and responded to. Although the documented quality assurance measures were limited, the registered manager had daily updates and was constantly reviewing service provision. They acknowledged they needed to develop some impartial monitoring and showed us the plans they had put in place.

Everyone we spoke with recommended the service and said nothing could be done better.

Rating at last inspection: Requires Improvement (report published 28 March 2018)

Why we inspected:

This was a planned inspection in conjunction with our inspection schedule.

Follow up:

The service will continue to be monitored in line with our inspection programme, and if information of concern is raised, this will be investigated.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 15 and 20 February 2018 and was announced. The provider was given short notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager would be available. This was the first inspection of the service since registration with the Care Quality Commission in February 2017.

Optimal Homecare Services 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 people over the age of 18 years. Not everyone using the agency receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection nine people were receiving personal care.

The service has a registered manager who is also the company director. 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.

This service is rated overall as requires improvement as CQC guidance states that a service cannot be rated any better than requires improvement if there is a breach of regulations. We found although many aspects of the staff recruitment process were thorough, the provider had not obtained any references for staff. The registered manager addressed this on the day of inspection by sending out reference requests for all the staff. However, references should have been obtained before any new staff member started employment as part of the process of ensuring staff were suitable and fit for the role. This was a breach in regulations.

People and relatives spoke highly of the personalised service provided by a small team of regular care staff who knew them well which included the registered manager. They said staff arrived on time and stayed the full length of the call. They described staff as wonderful, brilliant, caring and gentle. They said staff were patient and didn’t rush, giving them time to do things at their own pace. People’s privacy and dignity was respected. Medicines management was safe, although further guidance was needed in relation to ‘as required’ medicines.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care records were personalised providing detailed information about their needs and the support they required from staff at each call. Risk assessments showed any identified risks had been assessed and mitigated. We saw people and or/their relatives had been involved in their support plans and reviews. People’s nutritional needs were met and they were supported to access healthcare support as and when needed.

People we spoke with raised no concerns but knew the processes to follow if they had any complaints and were confident these would be dealt with.

Staff told us the induction and shadowing process was thorough and prepared them for their roles. We saw staff received the training and support they required to meet people’s needs. Staff had a good understanding of safeguarding.

People, relatives and staff praised the leadership and management of the service. They told us communication was good. People and relatives told us the registered manager checked with them regularly to make sure people were happy with the service. We saw systems were in place to monitor the quality of service delivery, however the registered manager recognised the recording of these processes needed to improve and was taking ste