Ur Choice Care Ltd is registered to provide personal care to people who live in their own homes. There were nine people receiving personal care from the service when we visited. This comprehensive inspection took place on 4 August 2016 and was announced. It was carried out by one inspector.

There was a registered manager 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.

Staff were knowledgeable about reporting any incidents of harm. There were a sufficient numbers of staff to provide the required care and recruitment procedures ensured that only suitable staff were employed.

There were effective procedures in place to ensure that people were safely assisted with their medicines.

The CQC is required by law to monitor the Mental Capacity Act 2005 (MCA). The provider was acting in accordance with the requirements of the MCA.. The registered manager demonstrated how they supported people to make decisions about their care and where they were unable to do so, there were records showing that decisions were being taken in people’s best interests.

Staff were supported and trained to do their job and additional training was provided for people's specific care needs to be fully met. The staff were in contact with health care professionals to ensure that care and support was well coordinated. Risk assessments were in place to help ensure that care and support could be safely provided.

People were treated by kind staff who they liked. They and their relatives were given opportunities to be involved in the review of their individual care plans. People’s privacy and dignity was respected and their support was provided in a caring and a patient way.

People were supported, where required, to ensure they ate and drank sufficient quantities and people were able to make choices about the meals and drinks provided.

Care and support was provided based on people’s individual personal and social care needs.

There was a process in place so that people’s concerns and complaints were listened to and these were acted upon.

There were quality assurance processes and procedures in place to monitor the quality and safety of the service and people’s care. People were able to make choices in relation to the support and care that was provided.

A single adult social care inspector carried out this inspection to follow up concerns identified during our previous inspection of 11 October 2013. One of the key questions we ask ourselves during an inspection is whether the service is effective. During our October 2013 inspection we identified that training had not been provided to ensure that staff could help meet the needs of people living with dementia. In addition, we were unable to confirm that staff had completed induction training. This meant that the service was not operating effectively because people were not cared for by staff that had received appropriate training or induction.

Is it effective?

This inspection established that improvements had been made. We noted that all staff now undertook training in dementia. We also found, through a random sample of staff records, that staff had completed the provider’s induction programme before commencing duties. Consequently, the service was effective in ensuring that people were supported by staff who had received suitable training and induction.

We asked each person if they felt staff were respectful and ensured their dignity was maintained. We asked one person if they felt the carers that came in to their home respected their dignity, they responded; “Quite, it hasn’t worried me at all. I do not feel uncomfortable and I am always provided with a lady carer, which is my preference.”

People we spoke with told us that they could not fault the service at all. One person told us, “They are brilliant and they always go that extra mile.” and another person stated, “I have no concerns at all, the staff are very competent and they have helped my condition improve.” A third person told us, “I have been happy with every aspect of the service I have received – they go above and beyond what is required.”

All the people we spoke with told us that they felt safe whilst receiving care and support from this service. One person commented, “Yes, I do feel safe, the carers that come in to my home are very trustworthy, of course I was apprehensive at first but I now feel at ease with them around."

When we reviewed staff files and spoke with staff members we found that the service had not ensured it provided an effective induction programme or specialised training to help meet the needs of the people they were caring for.