About the service: Way Ahead Care – Bath and North East Somerset LTD is a domiciliary care service that was providing personal care to 94 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

The provider looked for ways to improve the service and the quality of care provided, this included operating a ‘positive complaints’ policy and speaking with professionals about how they could work together to improve the lives of people.

People told us their wishes were respected. Care plans included information important to the person, which promoted independence and was personalised to meet individual needs.

People told us that they were cared for by well-trained staff. Staff received training relevant to their role and told us the training they received was very good.

Staff, people and relatives spoke positively about the registered manager and management team. Staff told us that they felt well-supported and the registered manager was accessible to people and staff.

Staff who visited with people were kind and caring and people confirmed this. People received a service that was responsive to their needs and were involved with planning and reviewing their care.

The provider had an open and honest culture, when things went wrong the service apologised to people and looked to make changes to prevent a recurrence.

The service worked with others to explore ways that could improve the lives of people. For example, providing unpaid carers with the opportunity to access complimentary training sessions.

The provider had a programme of quality audits in place and reviewed and analysed information to identify potential themes and trends.

The service worked effectively with healthcare professionals to ensure good outcomes for people.

Rating at last inspection: ‘Good’ (September 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 22 and 23 August 2016. The provider was given 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available at the office.

Way Ahead Care provides personal care and support to older people who live their own homes There are 150 people receiving support with personal care.

At the last inspection of the service in 18 February 2014 we found the service was meeting the regulations.

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.

People and their relatives were positive about the way staff treated them. Each person we spoke with told us their care workers were kind, thoughtful and efficient. People were happy and relaxed with staff when we visited them in their homes. Staff treated people with respect and kindness. People and their relatives responded to this by smiling and engaging with staff in a friendly way.

People and their relatives told us they felt safe with staff who provided their care. People told us they generally had the same carers and felt safe with them and had no worries when carers were in the house. There was an on call system for people to ring in the event of an emergency out of office hours.

Care plans described the support people needed to with 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 interacting with people in a friendly manner and responding to their requests to meet their needs.

Most people had a regular team of staff who had the skills to meet their needs. Nearly everyone we spoke with said it was very important that they got the same care staff as far as possible because they were not comfortable when their regular carers were changed.

.

Rotas were sent out to people each week with visit times and the names of staff who would support them. The service was flexible and responsive to changes in people’s needs. For example, people told us they had their own routines and that the service was always flexible.

Safe staff recruitment procedures were in place. These helped reduce the risk of the provider employing a person who may be a risk to vulnerable people. People were protected by staff who had completed safeguarding training and knew what to do if they were concerned that a person was being abused. Staff told us they had completed training on safeguarding people from abuse.

Risk assessments had been undertaken and included information about action to be taken to minimise potential harm occurring to people and staff. 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.

Staff told us they worked well as a team and found the registered manager and the care coordinators approachable. This meant that people were supported by staff who were effective in their roles.

People felt that the management were responsive when they had any concerns or complaints. The provider had systems in place to assess and monitor the quality of care. The service encouraged feedback and used this to drive improvements.

People and their relatives and friends who responded to the questionnaires were satisfied with the care and treatment provided by the agency. The person we visited and their relative said the staff were good.

People told us their privacy and dignity was respected by the staff. We were told they had not experienced any form of discrimination from the staff.

People told us their care needs were reviewed and their care plans were updated following the reviews. Staff knew care plans directed them to meet people’s needs consistently and guided them on their changing needs.

People felt safe with the staff. The staff received safeguarding adults training and knew the procedure for reporting suspicions of abuse. Staff knew it was their duty to report any poor practice they may witness from other staff.

Staff received essential training to meet the needs of people and their performance was monitored.

There was an effective system to gain the views of people about the agency. People’s views about the service were taken seriously and used to improve the personal care delivered.

For this inspection we met with three people at their home, we spoke with six people on the phone and we met with four staff members. Five people told us they thought they received a good service. One person told us they had confidence in the Bath office but they still had concerns about the contacting the Taunton office at weekends. They told us "I rang for over an hour and then I gave up. I just wanted to know when they were coming to help me to bed. They were very late”.

Two people described the staff as “lovely”. One person told us “a lady came to see me to ask all about my past and about how I want things done. She came about three times in all".

Three people told us they have all of the contact details they need in their care folder and were all confident the service would respond to any complaints if they had them. They all said they would contact the office if they were unhappy. One person told us “I get a good service. I would ring the manager if I was unhappy”.

The manager told us “since our last inspection we have reviewed the way we complete assessments and updated people’s care plans. We have worked really hard to make sure we know people's life histories and the way they want us to care for them”.

We met with three people at their home. Two people told us that the thought that the service was good and the continuity of staff that came to their homes had improved over recent months. One person told us that they still had concerns about the lack of continuity of staff, the lack of contact if the staff member was delayed and the inconsistent care that their relative received from staff members.

One person told us “I am very satisfied with the care I receive and if I have any concerns I tell them and they listen”.

Two people described the staff as “kind”. One person told us “The girls are happy to do anything you ask”. One person told us “The staff are always changing. They are sometimes not very patient”.

Three people told us that they have all of the contact details they need in their care folder and were all confident that the service would respond to any complaints if they had them. They all said that they would contact the office if they were unhappy.