About the service: Agency assistance provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. At the time of our inspection there were 46 people receiving personal care from the service in 20 locations in Exmouth, Exeter, Budleigh Salterton and Bridgewater. Some of these were in shared houses and some in individual homes. Peoples ages ranged from 18 to 80 and they were living with a range of needs which included, learning disability, physical disability, mental health, autism, epilepsy and sensory impairment.

Agency Assistance support people for a minimum of four hours a day up to 24 hours a day. Since our last inspection the provider had moved their office to a new location which was on the same site as the day care service operated by the provider.

People’s experience of using this service:

People received care from staff who knew them well. People were involved in decisions about their care and these were respected. If they were unable to be involved, then the relevant individuals were asked to decide on their behalf. People said they were well cared for. Interactions were kind and caring.

Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. Medicine were managed safely. People were protected from abuse because staff understood how to keep them safe and were sure action would be taken if any concerns were raised. There was a system in place to manage complaints and people and staff felt listened to.

People’s care plans were personalised and included their preferred method of communication which was known, respected and met. Care reviews were carried out with people’s full involvement. People were supported to lead a healthy lifestyle and have access to healthcare services.

There were sufficient and suitable staff to meet people’s contractual agreements. Thorough recruitment checks were carried out. New staff received an induction that gave them the skills and confidence to carry out their role and responsibilities effectively.

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.

The management of the service were well liked and respected by the staff. Staff told us they were well supported. People knew how to make a complaint if necessary which helped ensure that people were safe and that the service met their needs and improved.

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

Rating at last inspection: Good (report published October 2016).

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

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

This inspection was announced and took place on 6 and 8 September 2016. We told the provider two days before our visit that we would be coming. This was because we wanted to make sure the information we needed would be available. The inspection was carried out by one adult social care inspector.

Agency Assistance provides personal care for adults of all ages. Most of the people live in shared,

supported living houses in Exmouth and surrounding areas. They also provide care to people living in their individual homes. At the time of our inspection, 22 people were being supported with personal care by Agency Assistance in ten locations. This is the part of the service we inspected as it is a regulated activity. The provider also operates a care agency service which provides care workers to other providers. They also run a day centre five days a week in the local area called ‘Happy Days’ where people they support can attend. The provider employed 115 staff the majority of whom could work with people receiving personal care. The registered person said, “Most staff start on the agency side of the work and when we get to know them and feel they are suited they might move to work in the units.”

We previously inspected the service in February 2014 and no breaches of regulations we inspected.

The provider’s office is in Exmouth. When we visited there was a registered manager in post, as is required. 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.

People were supported by sufficient numbers of care workers who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed the registered manager; registered person and care workers take the time to talk with people throughout our visit at people’s homes and at the day centre. People were relaxed and appeared comfortable in their company.

There were safe and robust recruitment procedures to help ensure that people received their support from care workers of suitable character to work with vulnerable adults. Care workers had received a full induction so they had the understanding and skills to support people.

Care workers relationships with people were caring and supportive. They offered care that was kind and compassionate; they respected people’s privacy and dignity and maintained people’s independence as much as possible.

The registered manager and care workers demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Care workers had had training about the Mental Capacity Act (2005). They understood the need to consider people's capacity to make decisions. Where there was a concern about a person's ability to make a decision, care workers described how they would work with the person, their family and health and social care professionals to decide what was in the person's best interests.

Policies and procedures were in place to ensure people were protected from the risk of abuse and avoidable harm. Care workers had received a range of training and information including safeguarding adults and they were confident they knew how to recognise and report potential abuse. People and relatives told us they felt the service was safe.

Care workers received a range of face to face training and regular support to keep their skills up to date in order to support people appropriately. Some care workers were working towards a higher qualification in health and social care.

Care workers spoke positively about the registered provider and registered manager, the teamwork and the open culture at the service.

Care records contained risk assessments and support plans which were regularly reviewed and also updated w

People received a good quality of care and support. Care plans reflected each person’s needs and preferences. Families were encouraged to be involved where the person wished it.

People told us they were included in the planning of their care. One person told us they “helped write my own plans to get it all as I wanted it”.

We spoke with five people who used the service, all of whom were complimentary. One person told us the staff were “lovely and kind”. Another person told us “I’m very happy with what the staff do when they visit”.

Staff we spoke with were caring and responded to people’s needs. Staff told us they felt supported by the agency and received good training in topics that helped them support people to the best of their abilities.

Staff were knowledgeable about keeping people safe. People told us they felt safe and confident to talk to staff if they had any concerns. One relative told us the staff were “very well trained up”, whilst another person told us they “knew their stuff”.

At the time of this inspection Agency Assistance were providing varied services to people. Assistance was given to people to enable them to live in their own homes or within a supported living environment. The agency also provided care workers to nursing and care homes.

People who used the service were positive about the way they were treated by care workers. Comments included, " I am happy". One relative told us “We are delighted with the care X receives. X has a wonderful, welcoming home now - the carers are first class, X’s welfare is their priority at all times.”

We spent two days carrying out the inspection. We visited the service's office in Exmouth. We spoke with the provider, the registered manager and three support workers. We met with seven people who used the services in their own homes.

One family representative told us,” We have never had any issues with Agency Assistance and would recommend them to other families needing care for a family member.

We saw that care plans were comprehensive and reflected the individual needs of the person they related to. People told us that they felt safe. There were effective recruitment procedures to ensure that staff were suitable to work with vulnerable people.

People who used the service were invited to give feedback and this was acted upon. The provider used a variety of quality assurance measures, including spot checks on care delivery. Records were up to date and kept securely.