We carried out an announced inspection of The Local Care Company on 08 June 2018. We also gathered the views of people who used the service and staff members via telephone calls between the 10 and 13 June 2018.

The Local Care Company is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using The Local Care Company receives regulated activity; the 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 consider any wider social care provided.

At the time of the inspection, there were 74 people receiving a regulated service from The Local Care Company.

We last inspected the service in June 2016 when we rated the overall service to be good. Although the service was rated as good overall, it was rated as requires improvement in the responsive key line of enquiry (KLOE). This was because we identified a breach of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; person centred care.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question; responsive to at least good. We received this in July 2016. During this inspection we found the provider had addressed the previous regulatory breach and was now meeting all requirements of the regulations.

At this inspection the rating for the responsive KLOE had improved to good. 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.

At the time of our inspection, there was a manager in post who had not yet been registered with the Care Quality Commission (CQC), however we saw evidence that this application had been submitted and their application was on going. 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.

All the people spoken with told us they were safe because of the care they received. We saw people were supported by a consistent staff team and they told us staff were punctual and reliable.

Risks to people had been assessed and were managed safely. People's health, dietary and fluid needs were identified and met. Processes were in place to safeguard people from the risk of abuse.

We found medicines were managed safely. The service had effective systems in place to ensure medicines were given appropriately.

Staff continued to receive an effective induction in to the service and had ongoing training and support to meet the requirements of their role.

The staff were familiar with the requirements of the Mental Capacity Act 2005 and acted in accordance with this legislation.

People told us that the staff respected their privacy and dignity and promoted their independence where possible.

People were encouraged to make decisions and choices about their care and these were respected by the staff supporting them. They spoke fondly of the staff and regarded them as caring and considerate people.

People received personalised care that was responsive to their needs and care plans were complimented by electronic guidance which could be inputted and updated as changes in care needs occurred to ensure staff had access to the most up to date guidance.

People and staff were familiar with the complaints process and we saw complaints had been handled efficiently to support the complaint to be resolved.

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This inspection was undertaken on Tuesday 14 June 2016.

The Local Care Company is a care agency registered to provide personal care for adults in their own homes. The office is situated on one of the main roads, close to the town centre of Bolton. At the time of our inspection the service provided care and support to approximately 84 people, whilst also employing approximately 50 members of staff.

There was a registered manager 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.

The people we spoke with told us they felt safe. The staff we spoke with had a good understanding about safeguarding and whistleblowing procedures and told us they wouldn’t hesitate to report concerns.

We found medication was generally handled safely and people received their medicines at the times they needed it. We looked at how medication was handled at the two houses we visited. However, at one of the houses we visited, we found unexplained gaps in the staff signatures on the MAR (Medication Administration Records). We raised this concern with the manager who said they would be addressing this issue with staff.

The service used a call monitoring system. This enabled management and staff in the office to check care was being provided to people at the correct time of day and in line with people’s care package requirements. Staff spoken with didn’t raise any concerns about staffing numbers, with the service also actively recruiting new staff at the time of the inspection.

We saw staff were recruited safely, with appropriate checks undertaken before staff began working with vulnerable adults.

The service used an electronic training matrix to monitor the training requirements of staff. This showed us staff were trained in core subjects such as; safeguarding, moving and handling, medication and health and safety. We saw staff had not undertaken relevant training with regards to Mental Capacity Act/DoLS, although the manager told us they would look to book staff onto this course when they became available. Some other training courses were due for renewal, although the manager confirmed these had been booked for later in the year.

People told us staff helped them to maintain good nutrition and hydration. People said staff always left them with something to eat and drink before leaving their house.

We saw staff received regular supervision as part of their on-going development. This provided an opportunity to discuss their workload, concerns and training opportunities. We saw records were maintained to show these took place.

The people we spoke with told us they were happy with the care provided by the service. People told us staff treated them with dignity and respect and promoted their independence as much as possible.

Each person who used the service had a care plan in place and we saw a copy was kept in the person’s home and at the office. We looked at four care plans during the inspection. These were lacking in person centred information and did not contain sufficient information about people’s life histories, likes and dislikes. The tasks to be completed by staff were brief and did not contain information about how people liked their care to be delivered. This was a breach of regulation 9 (1) (c ) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to person centred care.

The service also sent satisfaction questionnaires to people, asking for their feedback about the service. We saw that where negative comments had been made, the service responded appropriately.

There was a complaint procedure in place. We saw complaints were responded to appropriately. The service user guide also clearly described the proces

Care files were maintained in a disjointed manner, however, the required information about the assessment and planning of care needs was documented.

When we spoke with people who used the service comments included: "I like the girls, they always arrive on time and treat me well" and "I have no complaints, the care is good, sometimes they are late but I don't mind, it's not often" and "Everything is fine, I wish they could come more".

We found the service had appropriate systems in place to ensure medicines were managed and administered in a safe and effective way. One relative raised an issue about the time medication was given and we discussed this with the provider.

We found service had systems in place which demonstrated staff were safely and effectively recruited.

There were adequate systems in place to assess and monitor the quality of the service provided. When we spoke with relatives of people who used the service we were told:" They do act on any issues you raise, so that's good", "I think the service is good, I have no complaints" and "They do what they are supposed to and are always pleasant, so that's a bonus".

Records were appropriately stored in a secure manner.

We found that The Local Care Company ensured that people who used the service had appropriate information about the services provided. A detailed service user guide was available and retained in the care file, which was left in the homes of each person.

People who used the service verified that discussions had taken place about their individual care needs during an initial assessment meeting.

People who used the service and relatives who we spoke with expressed confidence in the carers and that they felt that they could be trusted.

People who used the service told us: “I am very happy with the care I receive; I always feel that I can trust them (the care staff)”.

We visited 2 people who received care from the service. We found that care files were completed on every visit and these gave a good description of care given day to day. People who used the service confirmed that what the care staff documented within their file was what the carers had done. Daily visits were dated and signed.