This inspection took place on 05 and 7 July 2016. On the 07 July 2016 we contacted people and relatives to obtain feedback about the service they received. Raphael's Home care is a domiciliary care service that provides care and support to people in their homes. At the time of our inspection, Raphael's was providing support to 7 people.

There was a manager in post who had 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.

Potential risks to people’s health and well-being were identified by staff and they knew how to manage these effectively and protect people from harm. Risk assessments were completed to keep people safe.

People told us staff asked for their consent before providing care and support, care plans we looked at had consent to care forms signed by the people or their rightful representatives who received care and support.

People and their relatives told us that their family members were kept safe and well cared for when they were being supported by the service. Staff had received training in how to safeguard people from potential abuse and knew how to identify the risks associated with abuse.

Recruitment processes were robust and ensured staff employed to deliver care and support for people were of a good character and suitable to meet people`s needs safely. There were sufficient numbers of staff available to meet people’s individual needs, and the service provided was flexible.

People told us staff supported them to take their medicines. Staff were trained in safe administration of medicine practices and had their competency regularly observed.

People and their relatives were very complimentary about the abilities and experience of the staff that provided care and support. Staff received training when they were employed and regular updates to ensure they were up to date with their knowledge and best practice guidance.

Staff supported people to stay safe in their homes, and people were supported to maintain their health and well- being. Staff developed appropriate positive and caring relationships with the people they supported and their families, and feedback from people was consistently positive about the service they received.

People and their relatives where appropriate were involved in the initial planning of the care and support people received. People's personal information was stored securely and confidentiality was maintained.

People told us they felt the staff provided care and support that was delivered in a way that promoted their dignity and respected their privacy. Staff were knowledgeable about people`s preferred routines and delivered care that was individualised to the person they were supporting.

People told us they felt that staff listened to them and responded to them in a positive way. People and their relatives knew how to raise concerns and they were confident that the manager would take appropriate action to address any concerns in a timely way.

People were asked to provide feedback about the service they received regularly and we saw these were positive. The registered manager contacted an independent company to carry out a survey which included people who used the service, their relatives, staff and health and social care professional to gather feedback about the service they offered.

People and their relatives were positive about the staff and the management of the service. The registered manager regularly audited the service any improvements needed were actioned.

Raphael’s Home Care Limited provides care support to people living in their own homes. The service had a small client base and staff group which meant that the service was very person centred. During our visit we observed a number of staff attended the office to give feedback to managers, and or to give updates where they had observed a change in the person they were caring for. During the conversations we observed staff to have good rapport with the office staff and to have a comprehensive knowledge of the needs of the people who used the service.

People who used the service were complimentary about the standard of care they received and also about the staff who they described as "excellent". We were told by the provider that staff often worked beyond the call of duty and gave us an example where in the bad weather when there was snow, staff walked to the people who used the service, to ensure the service continued uninterrupted. We noted from staff work allocation's that people who used the service had "regular" care worker's which enabled staff to get to know people they cared for very well.

People received good care by staff who were supported to deliver a quality service.

Raphaels Home Care Limited provides support to people living in their own homes. The staff knew each other well and there was a great sense of unity and support between staff. People who used this service said that the care they received could not be of a better quality. They said that the staff were ‘a great bunch of people’ where nothing was too much trouble. People said that you never had to ask staff to do things, they would just use their initiative. The service provides care to people living at home which required the care staff to travel from one location to another. The people we spoke with said they liked the minimum unit of time of one hour per visit which enabled them to receive quality care. For example, if staff had finished the tasks detailed in the care plan, they would ask stay and spend time with the person and have a cup of tea and talk, which enhanced peoples wellbeing.

Raphael's Home Care is registered to provide personal care. At the time of our visit eight people were receiving a service. We gave the provide 48 hours’ notice of our visit to make sure the appropriate people were in the office. We visited the office on 15 and 17 October 2015. Between the 15 October and 22 October 2015, we spoke with care staff, people who used the service and their relatives or friends by phone to get feedback about the service.

The service has a registered manager. 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.

There were some systems in place to safeguard people from the risk of possible harm. There were risk assessments in place to provide guidance to staff on how risks to people could be managed and minimised. However improvements were required as there were no environmental risk assessments in place.

The provider had effective recruitment processes in place to ensure that staff employed to work for the service were fit and proper for their roles and of good character. There were sufficient numbers of staff to support people safely.

Staff were skilled and knowledgeable in how to support people in accordance with their agreed care plans. Staff received regular supervision and support, and had been trained to meet people’s individual needs.

Staff were aware of their responsibilities. However there were no systems in place to obtain peoples consent prior to care being provided and no assessments for people who lacked capacity.

People received care and support from a team of caring and respectful staff.

People’s needs had been assessed, and care plans included their individual needs. However care plans were not always personalised and did not demonstrate people’s preferences, and choices.

The provider had a formal process for handling complaints and concerns.

There were some quality monitoring processes in place. Regular spot checks had been carried out and some people’s views had been sought regarding the quality of the service.