Versacare are a specialist 24 hour live-in care Provider. The service provides care workers to enable people who require full-time 24 hour support remain in their own home. The live-in care service is delivered nationwide, with teams of field supervisors based in each region. People using the service ranged from young adults to the elderly. People had a range of needs including learning or physical disabilities and those with mental health or psychological issues. At the time of our inspection 85 people were using the live-in care service. In addition Versacare provided staff to work in 24 supported living units that were registered with other providers. In these situations Versacare was not the main provider of care but worked with the providers staff to provide care and support.

At the last inspection in July 2015, the service was rated Good.

At this inspection we found the service remained overall Good.

Care was tailored to meet the needs of each person using the service and people were complimentary about how the service recognised and responded to their needs. People and their relatives described staff as going “beyond the call of duty” and the service as “outstanding.” Staff knew the people they were supporting well and provided a personalised service for them. People and their relatives felt fully involved in creating their own care records. These focused on people as individuals and gave clear information and guidance to staff about how they would like their care delivered.

Changes in people’s needs were quickly identified and highlighted so staff were aware. Detailed staff handovers allowed time for care workers to truly understand how people like things done and the support they wanted. People who used the service felt able to make requests and express their opinions and views.

Staff used information in people’s care plans to help involve and encourage people to follow their own activities and interests both at home and in the wider community.

People told us they felt safe and that they trusted staff. There were processes in place to help make sure people were protected from the risk of abuse. Staff were aware of safeguarding adult’s procedures and understood how to safeguard the people they supported. Staff were up to date with training and the service followed appropriate recruitment practices.

People were very happy with their care and liked the staff that supported them, they told us staff were caring and respectful. People had the same staff to care for them and the service worked hard to make sure the right staff were matched with the right people at the start of the care package. When there were changes to staff, people said service would let them know.

Any risk that people may face was identified by risk assessments and appropriate plans were put in place to help keep them safe while still encouraging choice and independence. Care records and risk assessments were regularly reviewed. Staff supported people to attend appointments and liaised with their GP and other healthcare professionals to help meet their health needs. People were supported to take their medicine when they needed it.

People were asked about their food and drink choices. They felt involved in their daily menu and told us they enjoyed the food staff cooked and prepared for them. People and their relatives told us they would complain if they needed to, but most had never needed to. Everyone we spoke with knew who the managers were and felt comfortable speaking with them, the care staff or the office staff about any problems.

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.

People were contacted regularly to make sure they were happy with the service. Field staff carried out spot checks to review the quality of the care provided.

Further information is in the detailed findings

One inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

The summary is based on our observations during the inspection, speaking with fourteen of the people using the service and their relatives, speaking with five staff and from looking at records. We requested additional information from the provider, and we spoke with four regional placed local authority health and social care professionals who were involved in commissioning the care for some of the people using the service.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People we spoke with told us they felt safe and reassured because they had an experienced live in carer from Versacare Limited who helped keep them safe in their own homes.

The provider had developed care arrangements to minimise the risk of abuse and neglect. All staff received training on recognising and reporting abuse. They knew how to protect people that were vulnerable.

Peoples’ safety was promoted. The needs and associated risks to people using the service and staff were assessed and identified and plans were put in place to manage these appropriately.

Is the service effective?

People who used the services found the service worked hard to match the most suitable live in carer. Before a person received a service the provider identified the most appropriately skilled staff for the role, careful consideration was given to matching the “right person” for the role with strengths and skills considered. The provider undertook a home visit and introduced the live in carer first before they began work in a person’s home.

Care plans in place identified the physical health, mental health, social, financial and cultural needs of people who used the service and this information guided staff on providing the most appropriate care and support. The agency had processes for monitoring the care arrangements and staff practice, these included frequent spot checks.

People were supported by staff in accordance with their care plans. A health care professional from an NHS health trust told us they found that people using the service received the care and support they required.

Is the service caring?

The agency undertook a thorough vetting and recruitment process, from the interviews undertaken and from references supplied they assessed and selected people based on the qualities and attributes of candidates.

People using the service told us the care staff supplied were caring and patient, a person using the service said "my live in carer completes the tasks a caring relative would do." People found their views were acknowledged, they were offered choices and staff respected their preferences and daily routines, including respecting their homes.

Staff training included topics on promoting dignity and respect, and staff were able to tell us how they included this in their work with people.

Is the service responsive to people’s needs?

People, and those acting on their behalf told us they were fully involved in making decisions about their support. They said they were given information about the service of live in carers. People found this was a reliable responsive service, with a consistent team of experienced and skilled carers to provide the service. If a carer did not have the knowledge and understanding of a condition this was addressed through suitable training and support.

Is the service well-led?

The service has experienced consistency of management; there was a registered manager who was experienced and gave clear direction to the staff team. She was assisted by a team of experienced care managers (including a training manager) in coordinating a smooth operation at the agency.

People found the communication at the agency office was effective, a person using the service told us "information sharing is good, when I call up the information I give is shared with relevant parties, which helps promote good coordination in the service and avoid unnecessary calls."

There are processes in place to monitor the quality of service provision. The service obtained the views of people who used the service on a regular basis. Complaints were responded to appropriately and in a timely manner.

At the time of our inspection there were approximately 100 people who currently use the service in different parts of the country. To meet the needs of the people who use the service there are approximately 120 care workers.

We spoke with four people who use the service and or their carers by telephone. The feedback we received about peoples care and support was positive. One person told us “the carers are very good. They are always consistent with staff”. Another person told us “The carers are lovely”.

People we spoke with told us they had a good relationship with their carers and the service is organised well and is reliable. People who use the service informed us that the consistency with carers that visit is good. One person told us “I have had the same carer for some time. She is very good and she knows us and what our needs are”.

People who use the service told us that they knew who to speak with if they had a concern or compliant and they had been given information about who to contact if they were unhappy. This information is kept within their care plan record in people’s homes.

During our inspection we spoke with three members of staff. Staff told us they were well supported in their jobs when out in the community and daily communication with the office was good. Staff members informed us that Versacare’s training programme was very good because they ensured that all training remained up to date and was appropriate to individuals needs.

We spoke to some people using the service, some relatives and staff who lived or worked in various parts of the country. We also contacted some of the local authorities that commissioned services from Versacare.

People using the service said, "The service I receive is marvellous.I am very happy with my carer" and “I think Versacare is a very good service. They have a good understanding of my needs. I am very happy with the carer I have”.

Relatives of people using the service said, “We think the service is fantastic, we have no complaints. They go that extra mile to make sure everything is just right” and “I am very pleased with the quality of care my relative receives from the agency in fact they are excellent”.

All of the people using the service and their relatives we spoke to told us they were involved in planning their care needs. They told us that they knew who to speak to if they needed to make a complaint.

Staff told us they received lots of training and they had regular supervision and support from their managers.

Two local authorities that commission services from Versacare said they had no concerns about the service and considered them to be a good service. A social worker from another local authority said the service provided by Versacare was good.

We visited and spoke to a number of people who use the service and their care staff. One person who uses the service told us, "the staff are very good they treat me well, I have been very happy with the service".

All of the people we spoke to told us that they were involved in drawing up their care plans.

People told us they had good relationships with their regular staff, when the regular staff were not available, for example on annual leave, the service provided other staff who were competent and able to carry out the tasks as stated in their care plans.

Relatives of a person who uses the service told us “the service has made a big difference to ours and our sons lives, he is well supported by the service and is much more independent, we are very happy with the service”.

People told us that they knew who to speak to if they had any cause to complain. One person told us, “I can call the office if I have a complaint and I know they would do something about it”.

Care staff told us they had regular supervision and had received lots of training. They told us they were very well supported by the managers and they felt very happy to work for the service.

Versacare Limited are a specialist 24 hour Live-in Care Provider. The service provides care workers to enable people who require full-time 24 hour support remain in their own home. The live-in care service is delivered nationwide, with teams of field supervisors based in each region. People using the service range from young adults to the elderly, people with learning or physical disabilities and those with mental health or psychological issues.

We last inspected Versacare Limited in July 2014. At that inspection we found the service was meeting all the regulations that we assessed.

There was a registered manager in post at the time of our inspection, but they were not present during the inspection. 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.

People felt safe because the service protected them from avoidable harm and potential abuse, and minimised risks. The service did this consistently so that people felt safe in the home setting. People using the service told us that they felt safe having live in care workers, “It is reassuring having someone stay here in my home with me overnight.”

Staffing levels were consistently good, and regular care workers were assigned to cover the live in care worker role to the same people. Staff had time to develop positive and meaningful relationships with people which ensured they were more likely to recognise the signs if individuals were feeling unsafe.

The agency employed suitably trained and skilled care staff to meet people’s needs. The agency had robust recruitment procedures in place. These ensured that people who used the service could be confident staff were suitable and appropriately vetted for the work they undertook.

The service consistently promoted safe practice around medicines and infection control procedures. Staff were provided with protective clothing which they wore.

The care agency helped people to live their lives in the way they choose and to be as independent as possible, this promoted their well-being. For the majority of people with a live in care worker the option to remain their own home independently became a reality.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and could describe how they supported people to make decisions about their care and support. Staff told us they always asked the person first what they would like them to do, and did not make decisions for people.

The service had developed good links with health and social care professionals, who reported that the care staff actively promoted people to maintain good health by good monitoring and management of people’s nutrition and hydration.

The provider promoted a person centre care service. Staff relationships with people they supported were strong, caring and supportive. Staff told of feeling motivated and inspired to give care that was kind and compassionate. They displayed a determination to help people overcome obstacles to achieving this.

The service was well run, it sought ways to continually review their practice via the quality assurance process, and introduced ways to improve the service, and the care and support people received. People said they were impressed at how they ran the business, “They clearly answer your question about what they can and cannot offer and you get what they tell you.”

The service was flexible and responsive to people’s needs, The service had developed appropriate systems to make sure people’s wishes in relation to healthcare interventions, were respected at the end of their lives. Staff understood and recognised how to respond to people’s cultural diversity, values and beliefs, and how these influence individual decisions on how they want to receive care, treatment and support.