The unannounced inspection took place on the 12, 14 and 16 September 2016.

Royale Carers provides personal care and support to people in their own homes. At the time of inspection there were 39 people who used the service.

The service is required to and did have 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.

The service needed to improve their quality assurance systems. Monitoring systems were in the process of being developed to achieve robust quality monitoring of the service. Although systems were in place to make sure that people’s views were gathered, developments were being made to analyse and produce action plans to make effective use of people’s views.

There were sufficient staff employed to keep people safe and plans had been implemented to ensure adequate staffing levels were maintained. People were safeguarded from the potential of harm and their freedoms protected. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Care workers supported people with their medication as required.

Care workers were knowledgeable about their roles and responsibilities, had received regular training and instilled confidence in people. They had the skills, knowledge and experience required to support people with their care. The service worked well with other professionals to ensure that people's health needs were met. Where appropriate, support and guidance were sought from health care professionals, including dementia nurses and social workers.

Staff understood people's needs and treated people with dignity and respect. Care plans were in place detailing how people wished to be supported. People felt listened to and were involved in making decisions about their care. An open and inclusive culture had been formed.

There are currently four people using the service and we spoke with two of them. We also spoke with three of the relatives of people who use the service and another relative of a person who had recently used the service for a short period of time. All of the feedback was positive about the care that Royale Carers provided. Comments included, ‘very good service’, 'very good at communicating’, ‘nice carers’, ‘always on time’, ‘good notes’.

People’s needs had been fully assessed and their care plans clearly described the support that they needed. Care plans and risk assessments had been kept under review and they were updated to reflect any changing needs. People who use the service were protected from the risk of abuse. The premises were suitable for running a small agency.

The recruitment process had not been as robust as it could have been; however, the provider/manager has now taken steps to address this. Staff were trained and supported to do their work. One staff member said, “I have regular meetings with the provider/manager where we discuss training, she is very supportive.”

There were systems and processes in place for monitoring the quality of the service. People received safe, effective and compassionate care from a well led service that responds quickly to their changing needs.