This inspection was carried out on 9 August 2018 We gave the manager 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. The provider registered this service with us to provide personal care and support for people within their own homes. At the time of our inspection eight people received care and support from this service.

Rating at last inspection

At our last inspection on 17 June 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

People were protected from the risk of potential abuse and told us they felt safe in the company of carers because of the way carers supported and cared for them. Plans to manage people’s individual risks were assessed, and identified in a way which promoted people’s safety. There were enough carers employed to care for people and chat to them so they did not become isolated. Carers supported some people to take their medicines. Some people had requested carers just reminded them to take their medicines and this had been done.

People were supported to have maximum choice and control of their lives and carers support them in the least restrictive way possible; the policies and systems in the service support this practice.

Carers received training and ongoing support to help them work safely and effectively.

People were supported by carers to maintain their health and access professional medical advice

Carers treated people with kindness and took the time to get to know them well as individuals. People were encouraged and supported to express their views about the care and support provided.

People's rights to privacy, dignity and independence were consistently promoted by carers.

People received care and support designed around their individual needs and requirements.

People's care plans were detailed for each individual’s preferences so carers could deliver care in the way they preferred.

The registered manager promoted an open and inclusive culture within the service. Carers felt valued and well-supported in their work.

The management team carried out audits and checks to monitor and improve the quality of the service people received.

This inspection was carried out on 17 June 2015. We gave the manager 48 hour’s 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.

The provider registered this service with us to provide personal care and support for people within their own homes. At the time of our inspection 19 people received care and support from this service.

There was not a registered manager in post. However an application to register a manager had been made. 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.

When we last inspected the service in April 2014 we found the service did not meet all of the requirements of the regulations we assessed them against. However during this inspection we found them to be now meeting the requirements of the regulations.

People told us they found the staff and management approachable, willing to listen to their views and opinions. They said that if they had any concerns they were able to speak with the manager.

People told us that they always had the correct amount of staff to meet their needs and this included support with their medicines. Where staff were on holiday or sick, people told us that there were always staff on hand to cover any visits.

People we spoke with were positive about the care that they received. They told us staff were kind and caring and knew their needs. People told us they found the staff and management approachable, willing to listen to their views and opinions. They said that if they had any concerns they were able to speak with the registered manager.

Staff were not recruited until appropriate checks had been made to make sure they were suitable to support people in their homes and keep them safe. Staff had a good understanding of how to protect people from abuse and how to report abuse.

The manager told us that they were committed to achieving the best for the people that used the service. A range of checks were completed regularly to ensure that good standards of care were maintained. Feedback from the people that used the service were sought on a regular basis and any areas identified for action were acted upon.

People told us that nothing was done without their consent. Staff understood that care could only be given if the person consented and also the principles of personalised care.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the 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?

This is a summary of what we found-

Is the service safe?

People we spoke with told us they felt that their dignity was respected and they were involved in making decisions about their daily life. They considered they were well protected and supported. One person told us, “They are all very sensitive. I would definitely say something to (provider) if something was wrong”. The registered provider reviewed any incidents and discussed any improvements amongst the staff team.

Recruitment practices were not safe and thorough for new staff. The checks required by law had not been carried out before the staff member cared for people who used the service.

The provider was not aware of the local procedures for referring safeguarding concerns to the local authority. If those referrals are not made the local authority cannot investigate them and ensure that any victim is protected.

Is the service effective?

People’s on going needs were regularly re assessed and their care planned with them. People told us they had been satisfied with how they were accepted by the service. They said they had been asked about their preferences, choice and wishes before receiving any care. Staff we spoke with showed that they knew people’s needs well. This meant people were supported to maintain optimum health and well-being.

Is the service caring?

People we spoke with told us that staff treated them kindly and that their individual needs were met. People’s care was regularly reviewed with them and that they were encouraged to be as independent as they wanted to be. People told us that that they and their relatives were encouraged to make their views of the care known to staff.

Is the service responsive?

We saw that people’s views had been sought through a satisfaction survey. This meant that people could express their views anonymously if they wished. The provider was in day to day contact with people so any issues were discussed on an informal basis as and when they occurred. Contact with other health professionals ensured that people received external professional support where required. This meant people were supported to express their views and staff were responsive to their needs.

Is the service well led?

The registered manager had recently left the service and was in the process of applying to de-register with us. The provider said they will be putting forward a candidate for registration with us in the near future.

The service worked well with other agencies and services to make sure people received their care in a joined up manner.

We saw that staff practice was monitored and questioned and concerns dealt with. This meant the service had reviewed the care offered and recognised the need to improve when needed.

Staff told us that they felt supported by their manager.

Staff told us they were clear about their roles and responsibilities. Quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.