About the service:

Swallow Community Care is a domiciliary care agency that was providing personal care and support for five people living in their own homes aged 65 and over. At the time of the inspection; two other people were also being supported, but were not in receipt of a regulated activity.

People’s experience of using this service:

Staff had awareness of safeguarding and knew how to raise concerns. Steps were taken to minimise risk where possible.

Systems were in place to recruit staff safely and they were equipped with the skills required to provide effective care and support.

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 supported people to access other healthcare professionals when required. Staff supported people to manage their medicines safely.

People were supported by a small group of regular staff which provided continuity and familiarity. Staff had developed relationships with people and knew them well; people received person-centred care as a result.

Staff promoted people's independence and treated them with dignity and respect.

People were involved in making decisions about their care and involved in reviews to ensure their care plans met their needs and supported them to achieve outcomes. Staff supported some people to access the community.

The service had an open and supportive culture. Systems were in place to monitor the quality and safety of care delivered. There was evidence of improvement and learning from any actions identified.

There were sufficient numbers of trained staff to support people safely. Recruitment processes were robust and helped to ensure staff were appropriate to work with vulnerable people.

People’s needs were thoroughly assessed before starting with the service. People and their relatives, where appropriate, had been involved in the care planning process.

Staff were competent and had the skills and knowledge to enable them to support people safely and effectively. Staff received the training and support they needed to carry out their roles effectively. Staff received regular supervisions and annual appraisals were planned.

People were supported in a friendly and respectful way. People and their relatives were complimentary about the staff and their caring attitude.

People’s care plans were person-centred and provided staff with the information they needed to provide care and support in a way that met people’s needs and preferences. There was evidence that care plans were reviewed regularly or as people’s needs changed.

People knew how to make a complaint, although no formal complaints had been made to the service. There was an effective complaints process in place to deal with any complaints that might be raised in the future.

The registered manager and staff were committed to providing high quality care and support for people.

Rating at last inspection:

At our last inspection the service achieved an overall rating of Good; the report was published on 21 March 2016. The overall rating for this service has remained Good.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

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

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We undertook an announced inspection on 17 February 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.

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 seven people received support with personal care.

There was a registered manager for this service. A registered manager 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 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. People were supported to eat and drink well, when identified as part of their care planning. Relatives told us they were 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. We saw there was effective communication with people, staff and health care professionals.

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 that were trained and knew about 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 to support people. Staff always ensured people gave their consent to the support they received. The management team regularly reviewed how people were supported to make decisions. There were no applications to the court of protection to deprive people of their liberty.

People and their relatives knew how to raise complaints and the management team had arrangements in place to ensure people were listened to and appropriate action taken. Staff were involved in regular meetings, training and one to one’s to share their views and concerns about the quality of the service. People and staff said the management team were accessible and supportive to them.

The management team monitored the quality of the service in an inclusive way. The registered manager ensured there was a culture of openness and inclusion for people using the service and staff. The management team had systems in place to identify improvements and action them in a timely way.

This agency provided care for adults in their own homes. During this inspection we spoke on the telephone with three people who used the agency and two relatives. We spoke with the provider and registered manager, and three care staff at the agency office.

People we spoke with were complimentary about the care and support that they received. People said: “It’s a marvellous service”. “It is nice to be treated with respect”. People told us that they felt involved in any decisions that needed to be made about their care and these were made in their best interests.

We found that proper steps had been taken to ensure that individualised care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. One person said: “They have always done their best for me”.

Staff had been recruited in an appropriate way and checks had been undertaken that ensured they were suitable to care for vulnerable people.

The provider had systems of audit in place to enable them to monitor the quality of the service provided to ensure that people received appropriate care and treatment. We found that any comments and complaints people made were responded to appropriately.

We visited the agency office and spoke on the telephone with people who used the agency. We found that people were able to express their views and had been involved in making decisions about their care and treatment.

We found that care and treatment had been planned and delivered in a way that met with the essential standards. We talked to four people about their experience of the care and service they received from the agency. They were all very complimentary about the care and support that they received from the agency. People told us the agency was “excellent never had any complaints”, “I have the same carers every week, and they are very good”. “They look after me well and do everything which is necessary”.

We found that people who used the service were protected from the risk of abuse. People told us that they felt “totally” safe whilst receiving care from the agency.

People told us that they received a good standard of care from the staff who worked for the agency. They told us the staff were “really very good indeed”. Another person said “I get on well with all carers, they are real friends”. We found that staff had received appropriate induction and supervision, although there were some shortfalls in core mandatory training for several staff. This meant that staff may not have had up to date skills and knowledge to deliver care and treatment to the people who used the agency.

We found that the provider had an effective system in place to regularly assess and monitor the quality of service that people received.