Santa Monica Healthcare Group provides domiciliary services to people who require support in their home within the Newton-Le-Willows, Cheshire areas. The service covers a wide range of dependency needs including Older People, Physical Disability, Sensory Impairment and younger adults. The service operates seven days a week and has out of hours contacts.

At our last inspection 04 March 2016, we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place. 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.

Procedures were in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided by staff at Santa Monica Healthcare.

The registered manager had the same good systems for recruiting staff in place from the previous inspection. Also they monitored and regularly assessed staffing levels to ensure sufficient staff were available to provide support for people in their home.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

People who received support in their own homes told us they felt safe in the care of Santa Monica staff. A person who used the service said, “I feel safe knowing they are in the same block. They are so kind and caring.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Care plan information focused on a person-centred method of supporting people. In addition, information contained what support was required to maintain their independence.

People who used Santa Monica Healthcare had their support needs planned with them. People told us they had been consulted and listened to about how their care would be delivered.

During the inspection visit we spoke with people who used the agency. People told us staff were kind, respectful and attentive towards them. They said staff were caring, sensitive and patient. One person who received a service said, “They do respect this is my home. They always knock first and shout who they are.”

People who used the service knew how to complain and the system to go through should they need to. No complaints had been received however the registered manager was aware of how to respond to any concerns.

The service used a variety of methods to assess and monitor the quality of the service. These included, spot checks in people’s homes, satisfaction surveys and care reviews. People supported by the agency confirmed they had regular contact from the management team to ensure they were satisfied with the service.

The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.

Further information is in the detailed findings below.

The inspection took place on 4 and 8 March 2016 and was announced. Santa Monica Healthcare is a domiciliary care service that provides a personal care to people living in their own home. On the day of the inspection fifteen people were supported by Santa Monica Healthcare with their personal care and support needs.

The service had 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.

During our inspection we observed staff within the office who were friendly and relaxed and there was a calm and pleasant atmosphere. Information we requested was supplied promptly, records were clear, easy to follow and detailed. People, those who matter to them, staff and professionals all spoke positively about the service. Comments included, “I am happy with everything, it’s all good”, “Staff go above and beyond, always helping and doing little extra’s that mean a lot” and “They go above and beyond my expectations”.

People valued their relationships with staff. People said they felt well cared for and that they mattered. One person said, “Staff help with anything I need, they are so helpful and friendly”. A relative commented, “I don’t know how I’d cope without them, all the staff are wonderful”.

People were supported by staff who encouraged them to remain as independent as possible. Staff had a good appreciation and understanding of how to respect people’s privacy and dignity.

People told us they felt safe. Staff had undertaken training on safeguarding adults from abuse and put their knowledge into practice. Where staff had raised alerts the service managed the concerns promptly and where required, conducted thorough investigations to protect people. People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults before they started their employment.

People were supported to take their medicines by staff that were appropriately trained. People were supported by staff teams that received training that reflected their individual needs and supported how they wanted and needed to receive their care and support. Staff put their training into practice and delivered good care. A health care professional commented that Santa Monica Healthcare staff had been pivotal in creating a very positive change for a person supported.

People and those who mattered to them were involved in identifying their needs and how they would like to be supported. People’s preferences were sought and respected and staff provided consistent personalised care and support. Staff responded quickly to people’s change in needs.

People’s risks were anticipated, identified and monitored. Staff managed risk effectively and actively supported people’s personal decisions. This ensured that people had control and independence in their lives. Risks were regularly reviewed and updated promptly following any changes in need.

People knew how to raise concerns and make complaints. People and their relatives who had raised

concerns confirmed they had been dealt with promptly and satisfactorily.

Staff described the management to be very open, supportive and approachable. Staff talked about their

jobs in a strong positive manner, and were highly motivated. Comments included, “Out of all the companies I have worked for, this is the best. There is nothing I do not like about my job” and “I love my job. I feel really valued and well supported”

There were effective quality assurance systems in place. Action was taken to address areas where practice could be improved and as a result, changes had been made to help ensure the service moved forward and continually improved.

At the time of the inspection there were currently a small number of clients receiving support. We spoke with a range of people about the agency. They included the manager, staff, and one of the clients receiving support. We also had responses from external agencies including social services. This helped us to gain a balanced overview of what people experienced using the agency.

People who used the agency told us they provided a good service. Comments included, “The staff are all very good. They are always on time and get on with the job”.

Those we spoke with told us they had received a visit from senior staff before the service commenced. This was to introduce themselves and carry out an initial assessment. People told us their needs had been discussed and they had agreed with the support to be provided.

We found that there were enough skilled and experienced staff so that people had their care delivered at the right time. This was usually by the same people and in ways they wanted. One person who used the service said, “I am very confident they know what they are doing. I like the way they take time to talk with me, but they know when I want to be on my own”.