This inspection took place on 29 November 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to older adults and younger disabled adults living in their own homes. There were 30 people using the agency at the time of our inspection, 16 of whom received personal care. The registered provider of the service is Mr Ben Maynard, referred to in this report as ‘the provider’ and a manager was employed to run the agency.

At our last inspection in 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. The rating for the Responsive domain has improved to Outstanding.

Why the service is rated Good.

People received a service that was highly personalised and exceptionally responsive to their needs. They could rely on receiving the care they needed even if their plans changed at short notice or in an emergency. We heard many examples of the manager, the provider and staff responding quickly to keep people safe and secure when adverse events had occurred. Relatives told us they agency’s response to these events had been crucial in preventing harm and anxiety. All the people and relatives we spoke with said the agency had greatly exceeded their expectations in terms of its responsiveness.

People felt safe and secure when staff provided their care. Staff were trained to provide the support people needed safely and to use any equipment involved in their care. Any risks involved in people’s care were identified through assessment and action taken to minimise them.

Medicines were managed safely and equipment used in providing people’s care was serviced regularly to ensure it was safe for use. Staff helped people keep their homes safe and clean and maintained appropriate standards of infection control. The provider had a plan in place to ensure people’s care would not be interrupted in the event of an emergency.

People were protected by the provider’s recruitment procedures and staff were aware of their responsibilities should they suspect abuse was taking place.

Staff had the induction, training and support they needed to perform their roles. All staff had an induction when they started work and ongoing training relevant to the needs of the people they cared for. Staff attended regular one-to-one supervision with the manager, which gave them the opportunity to discuss their training and development needs.

People’s needs were assessed before they began to use the agency and kept under review. 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 supported this practice. Staff monitored people’s health and supported them to obtain treatment if they needed it.

Staff were kind and caring. They treated people with respect and maintained their dignity when providing their care. Staff supported people to maintain their independence where this was important to them. 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 supported this practice.

The manager, provider and staff had developed effective working relationships with other professionals involved in people’s care. This included specialist healthcare professionals to ensure people received the care they needed towards the end of their lives. The manager and provider planned and co-ordinated one person’s end-of-life care as their family did not live nearby. The manager and provider ensured the person was as involved as possible in making decisions about their care and adapted the care the person received at each stage of their life.

People and their relatives were encouraged to give feedback about the agency

The inspection took place on 16 March 2016 and was announced.

Staying At Home Care provides care and support to people in their own homes. The service provided personal care to nine people at the time of our inspection. The service is owned and operated by Mr Ben Maynard. Mr Maynard is registered with the CQC as the Responsible Individual for the provision of personal care. A Responsible Individual is a person who has the legal responsibility for meeting the requirements of the law. Mr Maynard manages the service on a day-to-day basis and is referred to in this report as ‘the provider’.

People felt safe when staff provided their care because their care workers understood their needs and any risks involved in their care. Relatives were confident their family members were safe when receiving their care. People told us that they could rely on their care workers. They said their care workers had never missed a visit and the agency contacted them to let them know if a care worker was running late. The provider had identified those people most at risk if their care was interrupted and had developed plans to prioritise the delivery of their care in the event of an emergency.

Staff received training in safeguarding and recognising the signs of abuse. The provider described situations in which staff had taken action to protect people and keep them safe. The agency carried out risk assessments to ensure that people receiving care and the staff supporting them were kept safe. Where an incident or accident had occurred, there was a record of how the event had occurred and what action could be taken to be taken to prevent a recurrence. People were protected by the provider’s recruitment procedures. The provider carried out pre-employment checks to ensure they employed suitable people to work at the agency.

People received their care from regular care workers who knew their needs well. New care workers were always introduced to people by the provider before they began to provide their care.

The provider understood the importance people placed on having regular care workers and ensured people received a consistent service from familiar staff.

Staff had access to the training and support they needed to fulfil their roles. All staff attended an induction when they joined the agency and shadowed experienced colleagues until the provider was confident in their ability to provide people’s care safely and effectively.

The agency worked co-operatively with people’s families to ensure they received the treatment they needed. Relatives told us staff were highly observant of any changes in their family member’s needs and said the provider contacted them if they had any concerns about people’s health or welfare.

People’s nutritional needs were assessed during their initial assessment and any dietary needs recorded in their care plans. Where people needed assistance with eating and drinking there was a care plan in place to outline the support they required.

People were supported by kind and caring staff. People told us their care workers were polite, courteous and treated them and their property with respect. They said they had developed good relationships with their care workers and looked forward to their visits. Relatives told us that care workers were compassionate in their approach and sensitive to their family members’ needs. They said staff knew how their family members preferred their care to be provided and genuinely cared about their welfare. The provider told us they only recruited staff with the attitude and approach to supporting people that reflected the agency’s values, including providing high quality care that promoted independence, dignity and respect.

People received a service that was responsive to their individual needs. They were able to request changes to their care at short notice and these requests were met. Relatives told us the flexibility the agency offered was one of its greatest strengths. They said it enab