The Care Company UK Limited is registered to provide personal care to people living at home. People receiving the care have a range of needs, which includes learning and physical disabilities.

At the time of this inspection care was provided to 103 people who lived at home.

This comprehensive inspection took place on 2 August 2016 and was announced.

The provider is required to have a registered manager as one of their conditions of registration. A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the agency. 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 staff were knowledgeable about reporting any incident of harm. People were looked after by enough staff to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service. People were supported to take their medicines as prescribed.

People were supported to eat and drink sufficient amounts of food and drink. They were also helped to access health care services and their individual health and nutritional needs were met.

The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA 2005] and the Deprivation of Liberty Safeguards [DoLS] and to report on what we find. The provider was aware of what they were required to do should any person lack mental capacity. People’s mental capacity was assessed and people were able to make decisions about their day-to-day care. Staff were trained and knowledgeable about the application of the MCA.

People were looked after by staff who were trained and supported to do their job.

People were looked after by kind staff who treated them with respect and dignity. They and their relatives were given opportunities to be involved in the setting up and review of people’s individual care plans.

Care was provided based on people’s individual needs and helped to reduce the risk of social isolation. There was a process in place so that people’s concerns and complaints were listened to and these were acted on.

The registered manager was supported by a team of management staff and care staff. Staff were supported and managed to look after people in a safe way. Staff, people and their relatives were able to make suggestions and actions were taken as a result. Quality monitoring procedures were in place and action was taken where improvements were identified.

There were systems in place to make sure that any person who used the service had their right to make decisions about their support and care valued and respected. People who used the service and their family members, where this was needed, were actively consulted in decision making processes.

People had positive comments about the standard and quality of the support and care provided. This had enabled people who used the service to remain living at home. People’s health and wellbeing was maintained and promoted as a result of the support and care that they had received.

There were systems in place to ensure that people were protected from the use of unsafe equipment. People told us that they were satisfied with how they were supported with the use of equipment.

There were sufficient staffing numbers available to ensure that people’s support and care needs were met in a timely manner. People had positive comments about staff members, including their competencies and caring attitude. They also told us that the stability of the staff team had provided them, or their relative, with a continuity of support and care.

Quality assurance systems were in place which took into account people’s views and comments. In addition, there were quality assurance systems in place to ensure that members of staff were competent and trained to safely do their job. Work was in progress to up-date people’s care records.

People that we spoke with were satisfied and complimentary regarding the carers and the care and support they provided. One person commented that, “The carers are very helpful and are always respectful.” The care plans we saw showed peoples’ preferences regarding how they would like their care and support to be delivered. However, some people did tell us that there were times where communication had been a problem with some carers whose first language was not English.

There were safeguarding procedures in place to protect people from harm. Staff had received training and they were clear about their responsibility in reporting any incidents or allegations of abuse.

There were induction programmes and mandatory training in place to ensure that staff were competent to deliver care. Care staff were supervised to monitor their work performance and development needs.

The agency had a procedure in place to deal with complaints that people might raise and a copy of the complaints procedure was available in their information pack. However, some people told us that communication with the agency’s office could be improved as they felt that their concerns had not always been dealt with to their satisfaction.

The majority of people with whom we spoke told us that staff are caring and gentle and that they could not do a better job. When we asked about any concerns or worries, we were told that people would feel confident about talking to staff and felt they would be listened to. We were told that the agency is good and that staff could not do any more than they now do and they are always keen to make certain all needs have been met before they leave.

We were told that people are treated with dignity and respect, one person stated that some staff can be ‘slap dash’ at times, but also said that two members of staff who attended regularly are ‘excellent’. They also stated that they do not talk to the agency about problems as they felt they are not listened to.

Many comments were about the difficulty with communication when staff do not have English as their first language. While members of staff are hard working and caring, it takes some time for the exact support to be provided in exactly the way a person wants. We were also told that once staff fully understand what is needed they are very good at their job. One person said that although things are mostly smooth now, ‘it’s the little things that make the difference. When it takes time and effort to get a meaning across, it can be very frustrating and also upsetting at times’.