This announced inspection took place on 12, 13, 19, and 20 March 2018. We visited the office on 12 March 2018 and carried out home visits to people on 13 March 2018. Phone calls to people who used the service and their relatives were made on 19 and 20 March 2018. The service was last inspected in December 2015 and was rated ‘good’.

The Bay Care Group is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older adults. Not everyone using The Bay Care Group receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 154 people were receiving personal care from the service. People who use the service live in Torbay, Newton Abbot and the surrounding areas.

The service had a registered manager. 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.

The management team placed a strong emphasis on providing a high quality service, looked for ways to continually improve, and was an excellent role model for other services. Community professionals were highly complementary about the quality of care provided. Comments included “As a provider they have always demonstrated they are forward thinking, have passion and care about their work”, “The staff have a genuinely caring attitude and are willing to work with professionals. I am hugely impressed by their commitment to the person and their family” and “There has been a need for quite a creative and very person-centred approach which Bay Care has achieved. The progress has been significant with really positive outcomes.”

The registered manager was the founder and co-chair of the local ‘Care Manager’s Network. One community professional told us “she’s doing a really great job and is very inspiring.” The network had received ‘Gold’ in the Torbay and South Devon NHS Trust Blue Shield Awards for Best Community Partnership. This award was designed to give recognition to hard work and dedication which improves the lives of people who use health and social care services. Staff worked in partnership with healthcare professionals to ensure ‘joined up’ care was delivered to people. This meant people benefited from high quality care and improved outcomes.

People and their relatives told us about the consistently high standards of management and care they received from The Bay Care Group. Comments included “The people who run it now are really on the ball”; “I don’t think I could do better anywhere else” and “The best I’ve ever used.”

Staff were highly motivated and were exceptionally kind, caring, and compassionate towards people they supported. Comments included “All the carers are excellent”, “We have a good old laugh” and “They look after me extremely well and instinctively know if I am having a bad day”. A relative wrote “She looks after my mum as if it was her own grandmother”. There were many examples of staff going over and above and the very positive impact this had on people’s lives.

The registered manager told us their focus was on caring and people were put at the centre of the service. The service had introduced ‘Operation connect’, an initiative to enable staff to engage more with the people they supported. Staff had taken time to gather the outcomes and goals that people wanted to achieve. They then worked with the person to realise those goals. People were invited to take part in the running of the service and were asked for regular feedback. This had resulted in improved outcomes for p

The Bay Care Group provides care and support to mostly older people, who live in their own homes. The services provided include personal care, live in care, and domestic work in Paignton, Torquay, Brixham, Dartmouth, Newton Abbot, Ashburton and the surrounding areas.

The service had a registered manager. 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.

We visited the office on 15 December 2015. At the time of this announced inspection 113 people were using the service. The service moved offices and was re-registered with the CQC in March 2015. Therefore, this was the first inspection to be carried out at this office.

People and their relatives were positive about the way staff treated them. Each person we spoke with told us their care workers were kind and compassionate. Comments included “They’re very good. Very pleased with them” and “Every single staff member is a star. They do a grand job, they’re dedicated”. People told us staff were respectful and polite. One person told us “They always start the visit with ‘how are you’ and ‘what can I do for you first’”. We saw staff and people interact in a friendly way. People were pleased to see the staff. The staff knew people’s interests and chatted with them about these with warmth and laughter.

People and their relatives told us they felt safe when staff were in their home and when they received care. People told us “I feel totally safe” and “I know them all”. Staff knew how to recognise signs of potential abuse and understood how to report any concerns in line with the service’s safeguarding policy.

People told us they were happy that staff knew how to meet their needs. People said “They do everything I need” and “They know what they’re doing”. Staff told us they were happy with the training they received. The service employed a training officer who provided face to face training. New staff completed training before going out to visit people. People told us they had a regular team of staff who had the appropriate skills to meet their needs. People said “I know them well”; “I’m very pleased with Bay Care” and “They do a fantastic job”.

People told us staff were usually on time. They said “It doesn’t matter what time they come, I know they will be there sooner or later” and “They are sometimes late, they mostly let me know”. Staff told us they were usually able to get to their visits on time. Two staff told us that sometimes there was not enough travel time. The registered manager told us they kept this under review and made changes where necessary.

Care plans were developed with the person. They described in detail the support the person needed to manage their day to day health needs. Staff knew people well and were able to tell us how they supported people. During a home visit, we saw staff responded to people’s requests, met their needs appropriately, and knew how they liked things to be done. The service was aware some people were at risk of becoming socially isolated. The registered manager regularly sent information out to people with details of what was happening locally, and where people could meet up.

Safe staff recruitment procedures were in place. The operations manager reviewed each staff file to ensure all checks had been completed before staff started work in people’s homes. This helped reduce the risk of the provider employing a person who may be a risk to vulnerable people.

Risk assessments had been undertaken and included information about action to be taken to minimise the chance of harm occurring to people. For example, where one person was at risk of pressure sores, we saw the person had equipment such as a pressure relieving mattress in place. Where people were supported to have their medicines this was done safely. People had received their medicines as they had been prescribed by their doctor to promote good health.

The service reviewed incidents and accidents to minimise the risk of them happening again. For example, the service had assessed one person as able to take their own medicines but on one occasion they took too many by accident. The service raised their concerns and the person’s care package was increased with more visits. The person agreed to staff giving them their medicines and a safe was installed to keep medicines secure.

The registered manager sought regular feedback from people who used the service. For example, through questionnaires, telephone calls, and meetings. The service had recently received 26 completed questionnaires. There were questions on respect, dignity, care plan involvement, likes and dislikes, and how well the service was meeting people’s needs. These were rated mostly good and outstanding. When asked the question does the service keep in touch with me regularly about concerns, some people rated this as adequate. Further to this, the registered manager had sent a letter to people telling people what was already in place. They asked people for any suggestions to make further improvements. People and their relatives felt able to raise concerns or make a complaint. People said “No complaints. If I wasn’t happy, I would soon let the office know” and “If I was worried I would speak with staff”.

The registered manager and the operations manager were working towards the Level 7 Diploma in Strategic Management. Staff told us the registered manager, operations manager and senior staff were all approachable and the door was always open. Staff told us there was open culture. One staff member commented “If you do something wrong, you can ring up and they’ll help you correct it”.

A comprehensive audit system was in place to monitor the quality of the service. Monthly audits were linked to the CQC’s five questions – safe, effective, caring, responsive and well-led. The audits looked at management, staffing, training, care plans, and records. There was a monthly checklist in place to ensure all quality measures had been carried out and completed. The service analysed the results of the audit. For example, they looked at the reason why visits were late. In November 2015, there had been some late visits due to traffic problems and hospital admissions. The service had informed people and given apologies.