We undertook an announced inspection of Rialto Care Services Limited Domiciliary Care Agency (DCA) on 12 November 2015. The provider was given 48 hours’ notice in order to ensure people we needed to speak with were available.

Rialto Care Services Limited is a small domiciliary care agency which provides support to adults in their own homes who have mental health issues, complex learning and/or physical difficulties, personality disorders and acquired brain injuries (ABI). At the time of our inspection Rialto Care was delivering services to eight people.

There was a registered manager in post at the time of our inspection. 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.

Most people who use the service told us they felt safe when the staff were in their homes. Family members we spoke with also told us they had no concerns and felt that their relative was well looked after. However, one person gave us feedback which suggested staffing levels in their relative’s home were not always safe.

Most people we spoke with and family members had good relationships with their staff teams and felt supported well by consistent staff that knew them well and understood their routines.

Staff were receiving regular supervision and appraisal, and training was provided so staff were supported and equipped with the skills needed to do their jobs. New staff were provided with a detailed induction programme, which included training in essential subjects and subjects which were specific to the person they were supporting.

The agency had robust recruitment practices in place. Applicants were assessed as suitable for their job roles. No staff commenced duties until all satisfactory checks, including Disclosure and Barring Service (DBS) check had been received. DBS checks identify if prospective staff have had a criminal record or have been barred from working with children or vulnerable people.

People received their medications safely and on time.

People were initially assessed by the operations manager before being offered a support package and we could see this had taken place.

Other assessments identified people’s specific health and care needs, their mental health, medicines management, and any equipment needed. A care plan was drawn up and agreed between the agency and the individual people concerned. Some people were supported by their family members to discuss their care needs, if this was their choice to do so.

Staff we spoke with told us their rotas were fair and they were happy with them.

People’s capacity to consent had been assessed and they had consented to their care and support. The provider had acted in accordance with their legal responsibilities under the Mental Capacity Act 2005.

Complaints had been logged and we could see that they had been investigated. People we spoke with told us they had never raised a complaint, and we could see that none had been raised in the last twelve months.

There were systems and processes in place to access the quality of service in the form of questionnaires sent out to people who use the service. The completed questionnaires had been analysed and the manager responded to these accordingly. We could also see other audits taking place on all records and documentation.

We visited one person who had complex needs who was receiving 24 hour care and support from Rialto Care in their own home. They appeared happy and settled and we observed a good rapport between the person and their support workers. They told us about their plans for later that day and what they had recently been doing. We found support was provided to maximise this person’s independence and to accommodate their own preferences.

We looked at four people’s care records and found clear evidence of people being involved in the planning of their care and support. People were asked for their consent before care was provided. People’s care records were comprehensive and contained all the information staff required to support people appropriately. The agency engaged well with other providers and information was held that could be taken with people if they required health treatment.

All members of staff went through recruitment checks to ensure they had the appropriate skills and values to undertake their roles. New members of staff were supported through induction and we were told this worked well.

An effective system was in place for complaints. People and their relatives had access to information about how to make a complaint. No complaints had been made in the last year.

We visited two people who were receiving care and support from Rialto Care in their own home. The people we spoke to told us about their views and experiences of the service they received. People told us they were satisfied with the care and support provided to them and that they were treated with respect. One person said “They [the staff] are alright.” Another person told us they were happy with the activities they did each day and that they felt safe.