About the service: Alexandras Commmunity Care Redruth is a domiciliary care agency. It provides personal care to people living in their own homes in Redruth and Camborne and the surrounding areas. At the time of the inspection 57 people were receiving personal care.

People’s experience of using this service:

¿ People told us they were happy with the care and support they received from the service. They were keen to tell us they felt involved in how their care was planned and were able to ask for changes if needed. Any requests for alterations to routines, or any concerns raised were addressed and action taken to make the necessary improvements.

¿ No-one reported having experienced any missed visits. Some people said the care workers were sometimes late but they would usually be informed if they were running behind. No-one identified this as being a problem.

¿ 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.

¿ Care plans were updated regularly and reflected people’s needs and preferences. Risk assessments were in place to indicate when people had been identified as being at risk because of their health needs, lifestyles or emotional well-being. There was a lack of guidance for staff on how to mitigate risks and we have made a recommendation about this in the report. However, staff knew people well and were able to explain how to support people according to their needs which they recognised could fluctuate.

¿ Staff were valued and well supported. Training was provided across a wide range of areas. This was usually delivered face to face and was designed to let staff gain a better understanding of the experience of living with various conditions.

¿ The service met the characteristics of ‘good’ in all of the key questions. Therefore, our overall rating for the service is ‘good.’ More information is in the full report.

Rating at last inspection: Good (report published 31 August 2016).

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

Follow up: We will continue to monitor the service and plan to inspect it in line with our re-inspection schedule. If we receive any information of concern we may bring our inspection forward.

Alexandra’s Community Care Redruth provides personal care to approximately 80 people who live in their own homes in and around Redruth and Camborne. On the day of our inspection the service employed 12 part time and 28 full time care staff.

This comprehensive inspection took place on 26 July 2016 and was announced in accordance with our current methodology for domiciliary care inspections. The service was last inspected on 12 February 2014 when it was fully complaint with the regulations.

The service had 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.

At the time of our inspection the service’s registered manager had been absent from the service for an extended period. The provider had informed the Care Quality Commission (CQC) of this period of absence and taken steps to ensure the staff team were appropriately led during this period. The service’s deputy manager had taken on responsibility for the day to day operation of the service with additional regular support from the provider’s operation manager and nominated individual. Staff were highly complementary of the deputy manager and told us, “[The deputy manager] is lovely, very fair and kind,” “[the deputy manager] is good as gold” and “I can’t praise [the deputy manager] enough she is absolutely amazing.”

People and their relatives told us they were happy with the care and support provided by the service. Comments we received included, “Oh yes, I am safe I look forward to them coming,” “The care is quite marvellous,” “I think all the girls do a brilliant job they are really good with [Person’s name]” and “It is extremely good as far as I am concerned.”

Staff visit schedules included appropriate amounts of travel time and call monitoring data and daily care records showed that staff normally arrived on time and stayed for the full planned care visit. People told us, “Yes, normally they are on time”, “most often they are on time, sometimes 15 minutes late but never more than that” and “They do stay for the full time.” During the inspection we saw no evidence that indicated any planned care visits had been missed and people told us they had not experienced missed care visits.

Records showed staff received regular training in a variety of topics to ensure they were sufficiently skilled to meet people’s needs and staff told us, “The training is good they do keep on top of it” and “I’ve done loads of training.” Staff told us they were well supported and records demonstrated they had received regular supervision, spot checks on their performance and annual appraisals. The service’s induction procedures for new staff were under review at the time of our inspection to ensure the training provided was equivalent to the requirements of the care certificate.

The service’s recruitment processes were safe. Staff understood their role in protecting people from abuse and avoidable harm. Information about local safeguarding procedures was displayed throughout the service office and available within each person’s care plan.

People’s care plans were sufficiently detailed to enable staff to meet their specific needs. These documents were regularly updated and accurately reflected people current care needs. People told us, “[The care plan] is quite comprehensive and is up to date” while staff commented, “There is one in every house” and “They are up to date, they tell you what you need to know.”

People’s care plans included risk assessments that provided staff with guidance on the action they must take to protect, both people and themselves from each identified risk. When accidents or incidents had occurred these events were reported to office staff. Each i

We spoke with eight people who used the service and three relatives. They told us that everything was absolutely fine. Several people told us the carers are usually on time and that they often get the same ones. This is good for continuity of care. Two people told us the carers are sometimes late but also said “They will phone us to say why they are late”. Another person said, “I receive good care and am kept informed”. One person said,”The carers are fantastic, they understand my complex needs, they are a skilled team”.

During our inspection, we spoke with the nominated Individual (head of service), registered manager, deputy manager and two care staff. They demonstrated a good knowledge of the care needs of people who received a service and they spoke fondly of each person.

We found peoples’ views and experiences had been taken into account in the way the service was provided and delivered in relation to their care.

People’s privacy and dignity was respected and people experienced care, treatment and support that met their needs and protected their rights.

We found that 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 happening.

We saw there were appropriate checks undertaken before staff commenced work for the service and that they were supported and trained.

We found the agency operated appropriate quality assurance systems.

People told us that the staff that visited them were usually good timekeepers, that it was usually the same carers, and people were positive about the carers themselves saying that they had no complaint about them as individuals or the care provided. People said they had confidence in the agency, and comments included: “superb people [staff]”; and “I don’t know what I would do without them”.

People told us they were aware of their care packages, and we found the care provided met people's expectations and needs.

People’s privacy, dignity and independence were respected.

People experienced care, treatment and support that met their needs and protected their rights.

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.

People were protected from the risk of infection and from unsafe or unsuitable equipment.

People were not fully protected from the risks of unsafe or inappropriate care and treatment arising from a lack of proper information in care records.