The inspection took place over two dates and was unannounced. On the 19 December 2016 we visited the registered office, met with some of the staff and viewed the paperwork, including care plans, staff files and other records relating to the management and running of the business. On the 23 December we accompanied a carer to visit some people who used the service. We also contacted a number of people, their relatives and staff to ask them about their experience of the care provided by the service.

The service provided domiciliary care and at the time of our visit was supporting approximately 87 people with a range of different support packages including domestic support, help with personal care and overnight sits.

The service had two registered managers 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.

The service was well managed with two registered managers both overseeing different areas. Together they formed an established team who knew their business well. They had worked within the care profession for many years and had extensive knowledge of the resources in the area and professional contacts. There were enough staff to deliver the care at the time they it was needed.

The feedback we received about the service was good. People using the service understood the role of the service and were positive about the care that they received and the management team. People knew how to contact the office and told us that they were kept informed if for any reason there was a change in the staff member providing their care or if staff were running late. People told us they had not had any missed calls and the agency provided a reliable service. People benefited from being supported by regular staff with whom they had established a strong bond and who were familiar with their needs.

Care plans were implemented quickly following an assessment of a person’s needs. Staff were familiar with people’s needs and referred to care plans to help inform their care practices. People told us care plans were not reviewed regularly and there was some discrepancy in how often they should be reviewed.

The agency had robust staff selection and recruitment procedures in place to help ensure only suitable staff were employed. Staff received excellent training and a thorough initial induction to help ensure they had the right competencies and skills to fulfil their role. The service also provided on going opportunities for staff to further develop their knowledge and skills. However, staff were not provided with regular formal supervision sessions and we were not assured that there were adequate systems in place to monitor staff competencies and practice

Some people required staff to administer their medication, whilst other people were able to take their own medication with staff prompting them when required. Training was given to staff and staff were observed by senior staff to ensure they were competent to undertake this task. However, we found that the auditing of medication records could be improved upon. We also had concerns about the processes that were in place to support a person who took their own medicines but were not consistently able to so reliably.

Staff knew how to safeguard people and protect them from abuse. Systems were in place to assess and manage potential risks to people. However, risk assessments needed to be more robust and the service were not adequately protecting people’s personal information. There were also systems in place to ensure risks were adequately managed. Risk assessments could be more robust. The service was not adequately protecting people’s personal information.

People gave their consent before care and trea

Records clearly explained how a person preferred to be supported. We saw information about the choices that had been made. Documents had the signature of the person concerned or a member of their family which showed their agreement to the care plan. This also showed that each person was fully consulted at every stage of their care.

We looked at four care plans for people who received support from the agency. Care plans contained detailed information that provided staff with enough information to meet the needs of people using the service. During our conversations with people using the agency and with family members, we were told that staff “Are wonderful and support independence.” When asked, people confirmed that any changes to their needs were supported and implemented immediately in their care plan. This meant that people retained total control over what assistance they received on a daily basis.

The provider ensured that safety checks such as Disclosure and Barring Service (DBS) and identity checks were completed for all staff prior to their commencing employment with the service. People we spoke with told us that they thought staff knew their job and that they knew how to provide any assistance in an appropriate way.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. The provider had taken steps to provide support and care from an environment that was adequately maintained.

The provider had an effective system to regularly assess and monitor the quality of the service that people received. Any necessary action was carried out and documents showed us that this was the procedure that had been followed.

We spoke to one person using the service and three relatives of people also using the service (over the telephone) who told us they were very pleased with the support and care provided. One person told us, “Carers always promote independence, privacy and dignity is always maintained and the care is always person-centred.”

We reviewed three people's care plans which documented personal information, emergency contact information, a safety inspection and manual handling risk assessment and saw copies of the person's personal plan.

We spoke to three carers (two over the telephone) who demonstrated a good understanding of safeguarding processes and told us what incidents or concerns they would report. They told us they were happy working for Phoenix Homecare (Norfolk) Ltd and felt supported by their managers and were able to discuss matters at any time.

The provider had systems in place to assess and monitor the quality of the services provided, including feedback from people using the service.