Ruby Care is a care service registered to provide personal care to people in their own homes (domiciliary care). The service specialises in providing a support to adults in the local community who live within a radius of seven miles from the service office. We announced our intention to inspect the domiciliary service so we could be sure the registered manager, care co-ordinator, staff and people receiving a service were available to talk to us.

At the last inspection in December 2015 the service was rated Good. We have not received any concerns about the service since then. At this inspection we found the service remained Good.

People we spoke to told us they felt safe with the staff who supported them. One person said “ I get very good care indeed. There are no worries with any of them.” A relative said “ they always ring if they are concerned. I put my trust in them.”

People received the particular care required to keep them safe in their own homes. They told us about the arrangements in place to enable staff to enter their homes safely and with regard to their privacy and independence.

The provider had systems and processes in place to keep people safe and minimise the risk of abuse. Potential new staff were thoroughly checked to make sure they were suitable to work with people in their own home. New staff were able to shadow experienced staff and did not complete visits to people alone until they felt confident.

People were supported by sufficient numbers of regular staff to meet their needs. People received reliable support from a team they knew. Staff arrived on time and did not let people down.

People were assessed to establish whether they needed or required assistance with medicines. Staff understood the varying levels of assistance that could be offered to people and the importance of clearly recording any medications they prompted or administered to people.

People received effective support from staff who had the skills and knowledge to meet their needs. People and their relatives felt confident that staff were trained and competent to deliver the range of care and support required.

People were supported to see healthcare professionals according to their individual needs. If they became unwell staff would contact family members or were able to call a doctor. When people needed to attend hospital the service offered flexible support by moving the time of their visits.

People only received care and support with their consent. Staff told us they always checked when entering people’s homes that they wanted care and support that day. One member of staff said “It is not just what is on the care plan. We always check what they want that day.”

People who received a service and their relatives told us staff were always kind and polite. Staff were described as “so kind” and “very pleasant” People valued the companionship they received from their regular carers.

People received a range of services according to their assessed needs and personal preferences. People could choose how much care they required. Some people received two visits weekly to assist with a shower . Other people required several visits a day to enable them to stay safely in their own homes. Staff knew people and if they were unwell or if a family member was away additional visits could be made on a short term basis.

People received care that was responsive to their needs because all staff involved in the service understood the importance of knowing people well and continually checking that the support they were providing continued to be what the person required.

The service was well led by the registered manager and care co-ordinator who put people receiving a service firmly at the centre of the service they provided. They listened to people and took action to ensure the service people received was reliable, flexible and caring.

Not everyone using Ruby Care receives regulated activity; CQC only inspects the service

This inspection took place on 29 October 2015. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available for the inspection. It also allowed us to arrange to visit people receiving a service in their own homes.

Ruby Care provides personal care to people living in their own homes in the immediate area around Wrantage, North Curry and Curry Rivel. At the time of this inspection they were providing personal care for three people. They also provided a domestic service to people in their own homes. This was the first inspection since the service was re-registered as a Limited Company.

There is a registered manager 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.

People who received personal care from Ruby Care told us they were happy with the care and support provided. They said the manager and staff were open and approachable and cared about their personal preferences and kept them involved in decision making around their care. One person said, “I have been involved from the start and regularly asked if I am still happy.” A relative said, “I am kept informed of everything and kept involved in decisions about care and what is needed.”

People were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed staff took time to talk with people during our home visits. One relative said, “There is always someone at the end of the phone. I know all the staff and can talk openly with the manager.” A staff member said, “It is like working with an extended family there are always enough of us around to make sure people are cared for properly.”

People told us they received care from care workers who were knowledgeable about their needs and were appropriately trained to meet them. Care workers had access to training specific to their roles and the needs of people for example they had attended training in the use of a new stand aid that had been provided for one person. They understood people’s needs and were able to explain to us how they would care for each person they visited. One staff member said, “We have daily contact with the manager or senior staff and the care plans are very clear and always kept up to date. If there are any sudden changes we are informed before we go to the person so we know.”

People’s care needs were recorded and reviewed regularly with senior staff and the person receiving the care or a relevant representative. All care plans included written consent to care. Care workers had comprehensive information and guidance in care plans to deliver consistent care the way people preferred. One relative said, “I rarely read the folder but I know the way my [relative] is cared for. We discuss the care plan with a member of staff ever month just in case there are any changes.”

The registered manager had a clear vision for the service provided. Their statement of purpose said, they aimed to provide a “Service that is driven by the needs and aspirations of our individual clients through listening to them.” Throughout the inspection we saw this vision was at the very centre of the care and support provided by all the care workers. Staff said they were aware of the philosophy of the service. One staff member said, “The manager speaks with us daily and the daily emphasis is on listening to people and providing the care they want as well as the care they need.”

People were protected from abuse because the provider had systems in place to ensure checks of new staffs characters and suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse.

Most people were able to access health care professionals independently but assistance could be provided if requested. Staff monitored people’s health with their consent and could direct to healthcare professionals as appropriate. The service also supported people with transport and a member of staff to GP’s or hospital appointments if requested.

The service had a complaints policy and procedure that was included in people’s care plans. People said they were aware of the procedure and knew who they could talk with. People and staff said they felt confident they could raise concerns with the registered manager and they would be dealt with appropriately.

There were systems in place to monitor the care provided and people’s views and opinions were sought on a daily basis. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.