About the service: Allcare Services and Training Limited is a domiciliary care agency. It provides personal care to adults living in their own houses and flats in the community. At the time of the inspection five people received personal care support from the service. The office is based in Bromyard Herefordshire. The service provides care and support varying from day visits to overnight support.

People’s experience of using this service:

Relatives told us family members were made safe by the care they received. Staff told us they had appropriate training, knowledge and support to keep people safe. Staff could tell us how they managed risk and behaviours that challenge while respecting the person and supporting their dignity.

Relatives felt confident in the management, they told us there was a caring culture within the service and staffing levels were appropriate. Relatives said it was beneficial the registered manager worked alongside staff delivering care.

We looked at how the management team planned their rotas. Staff were given travelling time between visits. The company director told us because the service was small it was easy to have clear oversight of the care delivered.

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 had been developed with people and their relatives being involved throughout the process. These were reviewed to reflect people’s current needs. The guidelines were comprehensive showing staff clearly what support was required. The management of risk was included within the care plan to minimise the likelihood of preventable harm occurring.

Staff files we looked at showed the registered manager used the same safe recruitment procedures we found at our last inspection. Staff told us training was ongoing and they received refresher training each year to update their knowledge.

There was a complaints procedure which was made available to people and their families. People we spoke with told us they had not made a formal complaint and were happy with the support they received. The service continued to have good oversight of relevant procedures through monitoring and auditing to ensure people received effective support and the service was well led.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included questionnaires to seek their views about the service provided.

The service engaged with outside agencies, health and social care professionals to ensure people received timely healthcare support.

Rating at last inspection: Good (Report published 25 August 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

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 issues or concerns are identified, we may inspect sooner.

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

Allcare Services and Training Limited (Allcare) is a domiciliary care agency registered to provide personal care to people of all ages living in their own homes. At the time of our inspection they were providing personal care to five people.

The inspection of this service took place on 13 July 2016 and was announced.

There was a registered manager in post but they were not present at the time of the office visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, registered managers 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 felt safe and well supported by staff from the agency. Staff offered safe care and support and knew how to recognise and report any risks, problems or potential signs of abuse. Risks were assessed and managed safely. Staff only had minimal involvement in administering medicines but systems were in place to promote safe practice.

People were supported by staff who had sufficient time to carry out tasks required of them and people enjoyed flexible and responsive support. Staff were recruited through safe recruitment practices.

Staff had the skills and knowledge to understand and support people’s individual needs. They received training and support when they started working for the agency and their skills were kept up to date through regular training which was currently being reviewed. Staff felt well supported by the registered manager and their colleagues.

Staff understood their roles and responsibilities and worked well as a team to ensure people’s needs were met effectively. People’s rights were protected under the Mental Capacity Act 2005 although staff knowledge in this area was an area identified for improvement, especially as people’s support needs changed and increased.

People were supported to prepare food and drink as per their plans of care. Staff worked with health professionals when required to ensure people’s continued good health and wellbeing.

People were supported by staff who were kind and caring. People had developed effective working relationships based on trust and mutual respect. Staff were aware of people’s individual preferences and respected their privacy and dignity. Staff promoted people’s independence and care was very person centred and individualised.

People, and their relatives, worked closely with the registered manager and the staff team to ensure they received a responsive service. They were asked if they were happy with the service provided. There were systems in place to ensure that people’s views and opinions were heard and their wishes acted upon. This process was largely informal due to the size of the service.

There was a complaints procedure in place although no one had had cause to use it.

The registered manager provided good leadership. There were systems in place to monitor the quality of the service provided. The providers were keen to learn from experiences and continually improve as the service developed.