This inspection took place on the 14, 17 and 22 November 2016. It was carried out by one inspector and one expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Weymouth Care at Home is registered to provide personal care to people living in their own homes. At the time of our inspection the service provided personal care and support for 137 people.

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 were positive about the care and support they received. They told us staff treated them kindly and we saw people were comfortable with staff in their homes. Staff were consistent in their knowledge of people’s care needs and spoke with confidence about the care they provided to meet those needs. They were motivated to provide the best care they could and told us they felt supported in their roles. They had received training that provided them with the necessary knowledge and skills to do their job effectively. Staff kept accurate records about the care they provided and these records were used to review people’s care.

There were enough safely recruited staff to ensure people received their visits as planned. People told us they mostly received visits on time and were contacted if the care worker was running late due to traffic or an emergency.

Staff understood how people made choices about the care they received, and encouraged people to make decisions about their care. Care plans reflected care was being delivered within the framework of the Mental Capacity Act 2005.

People felt safe. They were protected from harm because staff understood the risks they faced and how to reduce these risks. Staff knew how to identify and respond to abuse; including how to contact agencies they should report concerns about people’s care to.

People’s medicines and creams were administered safely although one person was not receiving their medicines at the correct time. This was rectified immediately.

People had access to health care professionals and were supported to maintain their health by staff. Staff understood changes in people’s health and shared the information necessary for people to receive safe care. Where people had their food and drink prepared by staff they told us this was prepared well. People were left with access to appropriate drinks and food between visits.

Management were committed to making continual improvements to the quality of care. This included development of new skills and expertise amongst the staff team such as the introduction of training in end of life care. There were systems in place to review and monitor the quality of the service people received including feedback from people and staff.

People were positive about the care they received and told us the staff were friendly and compassionate. Staff treated people and each other with respect and kindness throughout our inspection.

When we visited Weymouth – Care at Home on 13 March 2013, we looked at four sets of records relating to the delivery of care held at the office. We spoke with people working in the office, including the registered manager and a field work supervisor and then went on to contact nine members of staff by telephone. We also spoke with six people or their relatives who received care. We found that people were offered support at a level which ensured that their individual needs were met.

Care documentation gave staff clear guidance regarding the delivery of care, and each individual’s care plans reflected individual's personal preferences and wishes.

People told us that staff were friendly and polite in their approach. One person said, “I couldn’t fault anything about this service.” The staff that we spoke with were very knowledgeable about the people they cared for and felt well supported to undertake the role they were employed for. Without exception staff told us that they were happy in their job and believed they offered a good service. Many of the staff worried if they were delayed at a visit and late for the next call. People using the service were advised that a call could be 15 minutes different to that scheduled and if it were longer the provider would make contact with the person to advise them.

Records were well written and kept under review, and risk assessments were in place to minimise the risks and protect people in their homes.

We spoke, by telephone, with ten people who received care and with two relatives.

People we spoke with told us that they were very pleased with the service provided. They told us that staff were polite and courteous and maintained their privacy and dignity. They felt that their views and suggestions were listened to and taken into account.

People told us that staff were very patient and accommodating and they always asked if there was anything else they could do before they left. They said that staff knew how to cheer people up and they were very friendly. A family member told us that they were impressed with the level of care and concern shown by staff.

People told us they were involved in planning their care in partnership with staff and that the care provided was very good. People felt that they were understood and treated as individuals. They found staff very supportive over any issues relating to their health and wellbeing or practical issues.

Relatives told us they felt involved in the care and were able to contribute to reviews in care planning. They were informed if there were any concerns about the person’s health and wellbeing.

People told us that they felt safe with the staff providing care for them and that they knew how to raise any concerns. They told us that any concerns or queries were dealt with promptly. Those who had support with shopping were happy with the systems for checking money and receipts.

People thought that staff had been well trained and knew what they were doing. They told us that when a new member of staff started they always shadowed experienced staff before working alone.

People told us that staff gave them opportunity to give suggestions and feedback. Some told us they had completed a monitoring form when their care needs were reviewed.

A single inspector carried out this inspection. We considered our inspection findings to answer five questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led? Below is a summary of what we found. The summary describes what people using the service, their representatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Care was planned and delivered in a way that was intended to ensure people's safety and welfare. Risk assessments were regularly reviewed and amended according to changes identified. Effective assessment of care needs and management of risks showed how the service supported people’s welfare and took appropriate steps to ensure their safety.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Where potential abuse was identified appropriate steps were taken to notify key authorities, and to safeguard people from further harm.

The provider’s systems and training ensured staff worked in line with the Mental Capacity Act 2005 (MCA) and people were protected against the risk of unlawful or excessive control.

The provider had appropriate arrangements in place to ensure people were protected against the risks associated with medicines.

Is the service effective?

People’s needs were effectively identified and assessed, including in areas such as nutrition, mobility and personal care. Care plans to meet those identified needs were then clear and concise.

People’s needs continued to be met if and when they changed, because care plans were regularly reviewed and were updated as necessary following changes to people’s care needs.

Staff received regular and ongoing training related to meeting the needs of people at the service. This included administration of medicines, MCA, moving and handling and infection control. People using the service benefited from the provider taking steps to ensure staff were sufficiently qualified and skilled to provide effective care and support.

Is the service caring?

We spoke with 15 people who used the service and four of their representatives. They were all positive about the care and support provided by care staff. For example, one person who had used the service for a number of years told us, “All of them do 100%, many of them do 120%. They’ve become friends, not just carers.”

Is the service responsive?

The registered manager responded positively and swiftly to address in full any minor concerns we raised during this inspection.

People who used the service and their representatives told us they felt they could raise any shortfalls or concerns with management and they would be addressed.

Staff communicated with a range of different health professionals on an ongoing basis, which showed how they responded to ensure people’s changing health needs were met effectively.

Is the service well-led?

At our previous inspection we identified concerns across a number of different care standards and in regard to the level and quality of service provided. We found the provider had responded positively to the previous inspection’s findings and had taken steps necessary to address the concerns we had raised.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This reduced the risks to people and helped the service to continually improve.

If a staff member’s conduct fell below what was expected of them, we saw the registered manager took clear and proportionate action to address any performance concerns.

The provider and registered manager had appropriate experience of care provision and were knowledgeable about the systems and processes required for a domiciliary care agency’s successful operation. Effective leadership meant staff followed those systems and processes, which helped to ensure people’s care and support needs were met.