Solitaire Homecare Services Limited provide a Domiciliary Care Service to people living in their own home and is registered to provide personal care. They currently provide care for 107 service users

At the last rating inspection in January 2016, the service was rated Good. A subsequent focussed inspection in the area of Well Led, in May 2017, identified that there were areas for improvement regarding call times and management of concerns/complaints however, the rating remained as Good.

At this inspection we found the service remained Good.

There was 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 were kept safe and secure from risk of harm. Potential risks to people had been assessed and managed appropriately by the provider. People received their medicines safely and as prescribed and were supported by sufficient numbers of staff to ensure that risk of harm was minimised.

Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual care and support needs.

Staff sought people’s consent before providing care and support. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People were treated with kindness and compassion. People’s rights to privacy and confidentiality were respected by the staff that supported them and their dignity was maintained. People were supported to express their views and be actively involved in making decisions about their care and support needs.

People’s choices and independence were respected and promoted. Staff responded appropriately to people’s support needs. People received care from staff that knew them well.

People using the service, their relatives and staff were confident about approaching the registered manager if they needed to. The provider had effective auditing systems in place to monitor the effectiveness and quality of service provision. People’s views on the quality of the service were gathered and used to support service development.

This inspection took place on 05 May 2017 by one inspector and was unannounced. Solitaire is a domiciliary care agency registered to provide personal care to people living in their own homes. At the time of our inspection the service was provided to 130 people.

We undertook a focused inspection of Solitaire Home Care because we had received some concerns about the provider not responding to complaints or concerns, call cramming and the unprofessional conduct of the provider. Call cramming means that staff are required to attend more calls than time would allow, so each person’s allocated time would be shortened.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Solitaire Home Care on our website at www.cqc.org.uk’

The provider is required to have 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A registered manager was in post at the time of our inspection.

During this inspection we only looked at the whether the service was well led. Therefore we have not reassessed the overall rating of the service.

Staff felt supported by the management team and received training to ensure that they had the skills to support people with their care.

People felt that timing of call could improve to ensure that at weekends a consistent service was provided. Records of staff rotas were not always clear about the time of calls and where staff should be. On occasions rotas showed that staff were meant to be in two places at the same time. People did not always have their call on time and were not always notified if staff were going to be late.

The quality of the service was regularly monitored through a series of audits and checks. However some people felt that complaints were not always addressed to their satisfaction to ensure that people felt that their concerns were listened to.

Our inspection team was made up of a lead inspector. The summary is based on our observations during the inspection and from speaking with six staff. Following the inspection we spoke with five people who used the service and relatives. On the day of the inspection we looked at records including six individual support plans and five staff files. We also talked with the training provider for the service who was visiting the office to work with staff.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us that they were treated with respect and dignity by the staff and that they felt safe. Staff had received training in safeguarding and staff understood how to safeguard the people they supported. There was a current safeguarding notification and this had been managed according to the policies and procedures of the provider.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints and concerns. This reduced the risk to people and helped the service to continually improve. Risk assessments were in place in individual care plans in relation to all activities of daily living to ensure that support provided met people's needs.

Staff personnel records contained all the information required which meant that the provider could demonstrate that the staff employed to work in the home were suitable and had the skills and experience needed to care for people supported by the service.

Is the service effective?

People told us that they were happy with the care they received and felt that their needs were met. When we spoke with staff we found that they understood people's care and support needs and they knew them well. One person we spoke with told us, "It's the most fabulous service, it feels like we've got a friend come in, a professional friend." We saw from support plans that people's health and care needs were assessed with them and they were involved in writing their plans of care. The care plans had been signed by most people and where people had not signed the plans they had been signed by a relative. Specialist mobility and lifting and handling equipment needs had been identified in care plans where required.

Is the service caring?

People were supported by kind and attentive staff. We were told that support workers were patient and gave encouragement when caring for people. People told us they were able to do things at their own pace and were not rushed. One person we spoke with told us, "The carer says, 'take your time, don't rush." Where shortfalls or concerns were raised, these were addressed. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with their wishes.

Is the service responsive?

People who used the service understood how to contact the managers of the service if they had any concerns and knew how to make a complaint if they were unhappy. We saw evidence of 'spot checks' which were carried out throughout the service by the manager and we saw that issues identified from these were addressed in a timely way. We saw evidence that people's changing needs were reviewed and their plan of care amended to meet their new requirements for support and care.

Is the service well-led?

The service worked well with other agencies and services to ensure that people received their care in a joined up way.

The service had a quality assurance system which included planned audits which were undertaken at regular intervals with clear actions. Records seen by us showed that identified shortfalls were addressed promptly and as a result the service was constantly improving.

Staff told us that they felt well supported by managers and communication systems for ensuring that staff were up to date with any changes were in place.

On the day of our visit we spoke with three staff the manager and provider. Following our visit we spoke with eight people using the service, and three staff on the telephone. People told us that their needs were being met. One person told us, "I have no worries about the service. They come on time and are flexible and reliable." We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People’s care and health needs were planned and met in a personalised way. All staff spoken with told us they had the information they needed to care for people safely.

Staffs were clear about the action to take should they become aware of an allegation of abuse. All eight people spoken with told us they felt secure and knew who to tell if they had concerns and were confident that these would be acted upon.

Staff spoken with told us they felt supported by the manager, and had regular training opportunities. This meant staff had the skills to care for people safely.

There were systems in place to monitor how the service was run, and action was taken where feedback from the people using the service would improve the service provided to them.

We found that clear systems were in place to investigate and respond to people's concerns.

During our visit, we spoke with five people using the service, two relatives’ four staff and the provider. People were supported in a way that enabled their privacy, dignity and independence to be respected. One person using the service told us “staff always come on time so I know where I am’’. Another person told us “I have been using this service for three years I know the staff well”

All Staff spoken to were knowledgeable about people's care needs so that they were cared for appropriately.

We saw that systems were in place to keep people safe from harm.

Staff received a range of training so that they had up to date knowledge and skills in order to support people safely.

There were systems in place to monitor and seek feedback from the people using the service to ensure people received a quality service.

The people we spoke with who received personal care from the agency were happy with the quality of care received.

People told us that the agency had carried out an assessment of their needs before the service commenced. People 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.

People told us they were happy with the support they received and that it made a difference to their everyday living. People told us that they were treated with respect and that care staff maintained their privacy and dignity. They told us that care staff completed the care and support required. On the occasions when there was a delay in the arrival of care, people were informed in advance and upon their arrival care staff apologised for the delay.

This was an announced inspection, which took place on 5 and 12 November 2015 We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and we wanted to be sure that staff would be available.

Solitaire home care provides a personal care service to people living in their own homes. 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.

All the people we spoke with said they received a safe service. Clear procedures were in place to ensure that people received a service that was safe; staff followed the procedures to ensure the risk of harm to people was reduced.

People told us that they felt that there were enough staff employed to meet their needs and offer them a reliable and flexible service.

The risk of harm to people receiving a service was assessed and managed appropriately; this ensured that people received care and support in a safe way.

Where people received support from staff with taking prescribed medicines, this was done in a way that ensured the risk to people was minimised.

Everyone that used the service and their relatives felt the staff that supported them were trained and competent. Staff received the training development and support needed to ensure they did their job well and provided an effective service.

Staff practice ensured that people’s rights were protected.

People received support with their food and health care needs where required. People were able to raise their concerns or complaints and these were thoroughly investigated and responded to.

Everyone spoken with said they received a good quality service. The management of the service was stable, with robust processes in place to monitor the quality of the service.