About the service:

• Sevacare-Hall Green is registered to provider personal care to people living in their own homes. On the day of the inspection, 256 people were receiving support.

People’s experience of using this service:

• People continued to receive safe care. People felt safe within the service and there were enough care staff to keep them safe. Recruitment systems ensured appropriate care staff were appointed. People were administered their medicines as it was prescribed. Care staff had access to personal protective equipment and accidents and incidents were noted so trends could be monitored.

• People continued to receive effective care. Care staff had the skills, knowledge and support required to meet people’s needs. People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible. People decided the meals they had. Health care professionals were available to people as required.

• People continued to receive support from care staff that were of a caring nature. People decided how they were supported by care staff. Care staff were respectful of people’s privacy, dignity and independence.

• People continued to receive support that was responsive to their needs. People’s support needs were assessed and a care plan developed to show how people would be supported. The support people received was what they wanted and reviews took place. The provider had a complaints process in place that people were aware of and knew how to complain.

• The service did not continue to be well led. The registered manager was unable to demonstrate a good understanding of the service they were managing. Communication between the office and care staff needed to be improved to ensure actions were followed up on. The registered manager and provider carried out quality audits and spot checks to ensure people received a good quality service. Questionnaires were used to engage with people, but the outcome and actions resulting from the analysis was not shared with people so they would know how the service was being improved.

Rating at last inspection:

• Rated Good (Report published 28/07/2016).

Why we inspected:

• This was a planned inspection based on the rating at the last inspection. Whilst the service was rated ‘Requires Improvement’ in Well led, it remains rated Good overall.

Follow up:

• We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We undertook an announced inspection on 14 January 2016. We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their homes and or the family home; we needed to be sure that someone would be available at the office.

Sevacare Hall green is registered to provide personal care and support to people living in their own homes. The provider registered this service with us to provide personal care and support for people with a range of varying needs including dementia, who live in their own homes. At the time of our inspection 390 people received support with personal care.

There was a registered provider for this service. A registered provider is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 and their relatives said they were well supported by the staff and the management team. They told us staff were caring and treated them with dignity and respect. When identified as part of their care planning, people were supported to eat and drink well. Relatives told us they were always involved as part of the team to support their family member. People and their relatives told us staff would access health professionals as soon as they were needed.

Staff we spoke with recognised the different types of abuse. There were systems in place to guide staff in reporting any concerns. Staff were knowledgeable about how to manage people’s individual risks, and were able to respond to peoples’ needs. People were supported to receive their medicines by staff who were trained and aware of the risks associated with them. Staff really knew people well, and took people’s preferences into account and respected them. The management team were adaptable to changes in peoples’ needs and communicated changes to staff effectively.

Staff had up to date knowledge and training about how to support people. Staff ensured people gave their consent to the support they received. The management team took appropriate steps to ensure when people were supported with decisions these were done in their best interest.

People and their relatives knew how to raise complaints and were confident action would be taken when needed. The management team had arrangements in place to ensure people were listened to and action taken if required. Staff were encouraged to be involved in regular meetings to share their views and concerns about the quality of the service.

The management team monitored the quality of the service. The registered provider had systems in place to identify improvements and action them in a timely way.

The people we spoke with who received personal care from the agency were happy with the quality of care received. People told us “They know what they’re doing” and “They always ask if there is anything else they can do.” Another person said that the member of staff who regularly visited them was a “delight.”

People told us that the agency had carried out an assessment before the service started and that they had a copy of the care and support plan in their home. People we spoke with were confident that they could raise concerns if they were not happy with the care being received and that they would be listened to. One relative described a problem they had had with one member of staff and said that staff from the office “came straight out.”

People told us they were happy with the support they received and that it met their needs. People told us that they were treated with respect and that staff maintained their privacy and dignity. They told us that staff completed the care and support required. On occasions when staff were delayed, people described a mixture of experiences. Some said that the staff would telephone them to let them know they were late while others said they did not get advised of the delay.

During the inspection we sent questionnaires to 61 people that used the service and their relatives. A total of 20 questionnaires were returned to us, we received 13 responses from people that used the service and seven relatives. We spoke with a care service director, the manager and seven care workers.

Overall everyone that used the service and their relatives felt that their needs were being met. One person told us, “The carers ensure that the personal care that is done for me, meet my requirement.” We found that care and support was planned and delivered in a way that was intended to ensure people's safety and welfare.

We found that staff had training and equipment to ensure they protect people using the service from cross infection.

We found that people were cared for by staff that were suitably recruited.

Everyone that used the service and their relatives that responded to the questionnaires we sent felt that they were receiving a good quality service. One person told us, “In general the service which we receive is of good standard.” We found that the provider had an effective system to monitor the quality of service that people received.

We found that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.