Suffolk Coastal Home Care Service Home First provides an assessment and reablement service to people who require personal care, help with daily living activities and other practical tasks. This can include people who have not had care services before, who require care following discharge from hospital or whose care needs have recently changed. The service works alongside other agencies such as health and external care providers usually for the short term period of up to six weeks encouraging people to develop the confidence and skills to carry out these activities themselves and continue to live at home. People may be supported for a longer period of time; this is assessed on people’s individual needs. At the time of the inspection visit on 17 January 2019, the service was providing the regulatory activity of personal care to 39 people. This was an announced inspection. The provider was given notice of this inspection to make sure that someone was available to see us.

At the service’s last inspection of 31 May 2016, this service was rated good overall and in each key question. 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 were two registered managers in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 continued to receive a safe service. Risks to people were managed, including risks from abuse and in their daily lives. The service learned from incidents to improve practice. There were enough support workers to ensure that all planned visits for people were completed. Support workers were recruited safely. Where people required support with their medicines, staff followed safe practice. There were infection control processes to reduce the risks of cross infection.

People continued to receive an effective service. Support workers were trained to meet the needs of the people using the service. Where people required assistance with their dietary needs, this was provided. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide consistent care. The service understood and worked to the principles of the Mental Capacity Act 2005.

People continued to receive a caring service. People had positive relationships with their support workers. Staff respected and promoted people’s dignity, privacy and independence. People’s views were listened to and valued.

People continued to receive a responsive service. People received care and support which was assessed, planned for and delivered to meet their individual needs. A complaints procedure was in place, improvements were being made around how complaints were documented. There were no people using the service who required end of their life care, but systems were in place should this be required.

People continued to receive a service which was well-led. The registered managers were knowledgeable about their roles and responsibilities in providing people with good quality care. There were systems to assess and monitor the service provided and implement improvements where required. There was an open culture and people were encouraged to share their experiences of the service and these were used to drive improvement.

Suffolk Coastal Home Care Service Home First provides an assessment and re-ablement service to people who require personal care, help with daily living activities and other practical tasks. This can include people who have not had care services before, who require care following discharge from hospital or whose care needs have recently changed. The service works alongside other agencies such as health and external care providers usually for the short term period of six to ten weeks encouraging people to develop the confidence and skills to carry out these activities themselves and continue to live at home.

When we inspected on 31 May 2016 the service was providing the regulatory activity of personal care to 35 people. This was an announced inspection. The provider was given 48 hours’ notice because the location provides a care service within the community and we needed to know that someone would be available.

A registered manager was 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 told us they felt safe and received effective care from a consistent staff team who were competent and well trained.

Systems were in place which provided guidance for staff on how to safeguard the people who used the service from the potential risk of abuse. Staff understood their roles and responsibilities in keeping people safe and actions were taken when they were concerned about people’s safety.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

There were sufficient numbers of staff who had been recruited safely and who had the skills and knowledge to provide care and support to people in the way they preferred. Staff had developed good relationships with people who used the service and understood the need to obtain consent when providing care.

People received care and support which was planned and delivered to meet their specific needs. People and/or their representatives, where appropriate, were involved in making decisions about their care and support arrangements.

Where required people were safely supported with their dietary needs. Where staff had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.

A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

The service had an open and empowering culture. Staff understood their roles and responsibilities in providing safe and good quality care to the people who used the service. There was decisive leadership in the service. The service had a quality assurance system in place and as a result the quality of the service continued to improve.

We talked with six people who used the service to gain their views and experiences about the service they were provided with. They told us their needs were met and that staff treated them well. One person told us, “The staff are wonderful. I couldn’t fault them. It’s a damn good start to the day.” Another person said, “They (staff) are so good; really pleasant and helpful.”

People we spoke with confirmed they were consulted about the care and support that they were provided with and understood the care and treatment choices available to them. One person told us, “They (staff) are good. They listen to me and tidy up and put things back where I like them. They respect me and my things. That is important to me and they know that.” Another person said, “The care and support I receive from the staff has allowed me to regain some independence which I really appreciate.”

We looked at six people’s care records. The records showed that people's needs were assessed and care and treatment was planned in line with their individual care plan. We saw evidence in the care records that people received safe and coordinated care, treatment and support where more than one provider was involved.

We looked at staff records and spoke with three members of staff who told us they were being appropriately supervised and supported. Staff were knowledgeable about the people they supported and how to meet their needs.

We saw that the provider had a complaints system in place that was fit for purpose.

We spoke with six people who used the service who told us that they were consulted about the care they were provided with. One person said, “They (care workers) always do what I ask them to do.” Another person said, “They (care workers) have an excellent attitude and are always polite.”

People told us that the care workers treated them with respect. People told us that they felt that the support they received from the service met their needs. One person said, “They have improved XX's life a lot.” Another person said, “The system is very good indeed." People said that they had a copy of their care plan in their homes.

We looked at the care records of six people who used the service and found that people experienced care, treatment and support that met their needs and protected their rights.

Supervision and observation records showed that care workers were appropriately supervised and routinely observed by a senior member of staff.

We saw the results from the most recent satisfaction questionnaires which had been completed by people who used the service. The results were positive with high levels of satisfaction and 100% positive responses in relation to questions about feeling valued and respected, communication with the service and how the service promoted independence.

We visited three people who used the service in their homes. They told us that the care workers treated them with respect and that they listened and acted upon what they said. Two people said that the care workers were 'gentle' when they supported them with their personal care needs.

People told us that they were provided with a copy of their care plan and that the care workers supported them with the tasks that were identified in their care plans. They were consulted about the care and support that they were provided with. They said that the care workers stayed for the amount of time that they expected them to.