About the service: YS Services Limited trading as Embracing Care is a domiciliary care agency. It provides personal care and support to children and adults of all ages living in their own homes or in a 'supported living' setting, so that they can live as independently as possible. At the time of this inspection there were 683 people supported by the service.

People’s experience of using this service: People told us they received a good service and felt safe with the support they received from staff. Arrangements were in place to protect people from risks to their safety and welfare, including the risk of avoidable harm and abuse. Effective recruitment procedures were in place and people received care in a timely way. Arrangements were in place to protect people from the risks associated with the management of medicines and the spread of infection.

People’s care and support was based on detailed assessments and care plans which were regularly reviewed and updated. Staff received appropriate training and supervision to maintain and develop their skills and knowledge to support people according to their needs.

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 supported to eat and drink enough to maintain their health and welfare. People were supported to access healthcare services.

Staff had developed caring relationships with people they supported. People were supported to take part in decisions about their care and treatment and their views were listened to. Staff respected people’s independence, privacy and dignity.

People’s care and support considered their abilities, needs and preferences and reflected their physical, emotional and social needs. People were kept aware of the provider’s complaints procedures.

Effective management systems were in place to monitor the quality of the care provided and to promote people’s safety and welfare.

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

Rating at last inspection: The rating at the last inspection was Good. The report was published on 5 August 2016.

Why we inspected: This was a planned inspection. It was scheduled based on the rating at the last inspection.

Follow up: We will continue to monitor the service to make sure people receive safe, compassionate, high quality care. Further inspections will be planned for future dates in line with our inspection programme.

This inspection took place on 30 June and 1, 5, 11 July 2016 and was announced. This meant we gave the provider two days’ notice of our visit because we wanted to make sure people who used the service in their own homes and staff who were office based were available to talk with us.

YS Services Limited trading as Embracing Care is registered with the Care Quality Commission to provide personal care to people who wish to remain independent in their own homes. The agency provides services throughout areas of County Durham and provides a range of home care and support.

At the time of our visit there were approximately 492 people using this service who were supported by 148 staff.

There was a registered manager in place who had been in their present post at the service for over five years. Prior to this the registered manager had also worked in care and senior positions in the organisation. 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.

Everyone who was using the service had a care plan which described how their individual care and support needs were to be met. This meant that everyone was clear about how people were to be supported. These were evaluated, reviewed and updated as required. People who used the service and those who were important to them were actively involved in deciding how they wanted their care, treatment and support to be delivered. The registered provider had detailed plans in place to ensure care plans were accurate, easy to use and kept up to date.

The registered provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service. These included risks to service users and staff due to infections. We saw risk assessments were carried out, including reduction measures and these were updated if new situations or needs arose.

The registered provider operated recruitment procedures which were robust to protect people using the service from unsuitable staff. The provider undertook thorough background checks for staff before they started working with vulnerable people.

Feedback from people using the service showed that staff and the registered manager were friendly, open, caring and diligent; people using the service trusted them and valued the support they provided. People told us they were happy with the support from this agency and felt they were in control of the support they received.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.

We found the registered manager had a good understanding about how the service was required to uphold the principles of the MCA, people’s capacity and ensure decisions about their best interests were robust and their legal rights protected.

The registered manager and staff that we spoke with promoted peoples’ health and wellbeing and it was evident that staff knew people who used the service well. This included their personal preferences, likes and dislikes. Staff had used this knowledge to form caring and therapeutic relationships. These relationships improved the agency’s effectiveness and helped them make changes in response to people’s needs or in response to emerge

When we previously inspected the service in November 2013 we told the provider that they were not meeting this essential standard. We issued a formal warning notice to the provider. This explained the concerns we had, and told them they had to make changes to comply with the regulation. The reason for this visit was to check that improvements had been made.

We saw the provider had employed a member of staff for the purpose of writing care plans. All people who used the service were to have their care plans reviewed and re-written. We saw the provider had nearly completed this process and new care plans had been written for approximately 70% of people who used the service at our last inspection and for all people who had started using the service since the date of our last visit.

People who used the service told us they understood the care and treatment choices available to them, and that they were involved in making decisions about their care and treatment.

People told us they were treated respectfully by their care workers and that their privacy and dignity was maintained as far as possible. Comments included, “All very good – listen to what I tell them”.

Care and treatment was planned and delivered in a way that ensured people's safety and welfare. Most people we spoke with expressed satisfaction and were happy with the care provided. One person told us “The carers look after me well”.

We spoke with several people who used the service and their relatives. They told us carers who visited usually talked to them and discussed with them how they wanted to help people with their care needs. We were told by people who used the service and their relatives that some of the carers asked people if it was okay for them to assist with their personal care.

We spoke with some people about the care they received. One person told us “They (the care staff) are very good” another told us “One of them is very good. My (relative) is treated well.” We were also told “I can’t fault them (the care staff).”

In addition some of the other people who used the service told us “Some of the carers are more patient than others” and another person told us “My (relative) always appeared anxious when one of the carers came around.”

We saw the provider had ensured all staff working for the agency had undergone training in infection prevention and control. The provider told us all staff were required to wear personal protective equipment (PPE) and staff were provided with disposable gloves and aprons which they carried with them when going to visit people who used the service.

We saw the provider carried out an annual survey of the service with service users and their families. This helped to show what they thought was good about the service and where changes could be made. The survey responses were collated and action plans were devised.