The inspection was announced and took place on 24 October 2017.

Allen Auxiliary Limited is a small domiciliary care agency that provides personal care to adults living in their own homes who live in an area of Chichester, West Sussex. People who receive a service include those living with frailty or memory loss due to the progression of age, mobility needs and health conditions.

At the time of this inspection the agency was providing a service to 10 people, nine of who received personal care. Visits ranged from half an hour to over one hour. The frequency of visits range from one visit per week to four visits per day depending on people’s individual needs.

During our inspection the registered manager was present. The registered manager is also the owner of the agency. 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.

We previously inspected the service in May 2015 when it was rated ‘Good’ overall and in all domains apart from the ‘Well Led’ domain which was rated as ‘Requires Improvement.’ One breach of regulation was made for incomplete records. In response to this the provider sent us an action plan that detailed the steps that would be taken to achieve compliance. At this inspection we found that steps had been taken by the registered manager and that the breach of regulation was met.

Since our last in May 2015 steps had been taken to ensure records were accurate and up to date. In addition to people now having personalised care plans other documentation had also been reviewed and expanded to ensure it could be used to monitor the quality of service provided to people. This included the expansion of home visit audit forms and questionnaires sent to people to obtain their views.

As at our previous inspection, everyone that we spoke with praised the registered manager, care workers who visited them and expressed satisfaction with the service they received. There was a positive culture at the agency that was open, inclusive and empowering. People said that they were aware who to speak to in order to raise concerns. The agency had a complaints procedure in place to respond to people’s concerns and to drive improvement.

People told us that they felt safe with the care workers who supported them. Care workers received training and were knowledgeable in recognising signs of potential abuse and the relevant reporting procedures. Recruitment checks were completed to ensure care workers were safe to support people.

People said that they received care visits at the agreed times and that care workers always stayed for the full allocated time. Care workers also said that they had sufficient time to care for people safely.

Safe medicine systems were in place. Risks to people’s safety were assessed and action taken to reduce any harm to people. Care workers understood the procedures that should be followed in the event of an emergency or if a person was to have an accident or to fall.

People said that the registered manager and care workers had the appropriate skills to meet their needs and that they provided effective care. Both the registered manager and the care workers were knowledgeable about the people they supported. Care workers received support and training that equipped them with the skills and knowledge needed to care for people.

People were happy with the support they received to eat and drink and to manage any health needs they had. Care workers were provided with information before they started to care for people and were kept informed when people’s needs changed.

Both the registered manager and care workers understood people’s rights to be involved in decisions about their care and were able to explain what consent to

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records looked at.

If you'd like to see the evidence that supports our summary you can read the full report.

This is a summary of what we found:

Is the service safe?

Despite our best efforts we were only able to speak with one person using the service. They told us they felt safe when staff delivered personal care to them in their home. They added: "Before all this started I was dreading it but X (the member of staff) has been brilliant".

We looked at records relating to staff training and found that staff were trained to cope with emergencies they were likely to encounter in their work. We spoke with two members of staff who were able to explain what they would do if an emergency arose.

Is the service effective?

With permission, we observed care being delivered in one person's home. We found the member of staff to be respectful and encouraging to the person. We saw the member of staff encouraging the person to be as independent as possible whilst providing care.

Relatives we spoke with spoke highly of the agency. One relative told us "They're (the staff) very respectful. It's very encouraging to see".

Is the service caring?

The member of staff we observed was gentle and treated the person with dignity and empathy. Both members of staff we spoke with gave good answers when we asked how they involved people in their care. The two relatives we spoke with told us the care was very good. One relative said "The care is absolutely fantastic".

Is the service responsive?

Despite the fact that some care records were not updated regularly we found that the care provided by the agency met people's needs. Regular staff meetings ensured that staff had the opportunity to raise issues concerning people with the manager.

Relatives we spoke with were very happy with the way care was delivered and the person we managed to speak with told us "I do what I want when I want".

Is the service well-led?

We saw evidence of good care being provided by the agency. However we have asked the provider what they are going to do to meet the requirements of the law in relation to the way the service is run. This is because although the manager had high standards of care and supervised staff regularly, they did not have effective systems in place to monitor the quality of some aspects of care.

We spoke with two people who used the service and one relative. They were all happy with the care provided. One person said, "I would describe the care as absolutely excellent." Another person said that the care she received was "Very good indeed." They all said they had a copy of their care plan which reflected the care they received and met their individual needs. They said the care workers arrived on time and stayed for the amount of time required. They all said they felt the care workers were well trained for their job. One person said, "The staff know what they are doing, they are well trained."

The provider employed two care workers. We spoke with one of them. They said they had received sufficient training to undertake their role and received good support from their manager. We saw documented evidence that staff received regular training and supervision.

We looked at the care records of three people. We saw evidence that people's needs had been assessed and that care plans were in place. The people we spoke with said they had a copy of their care plan which reflected the care that was delivered.

During this inspection we found that people who used the service had been asked for their views about their care and treatment.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they could make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience, who has personal experience of using or caring for someone who uses this type of service.

We used telephone interviews and home visits to people who used the service and to their main carers (a relative or friend) to gain views about the service.

We visited two people in their own homes as part of this inspection and spoke with them about their experiences of the support they had received. We spoke with two of the four care workers and the registered manager. We also spoke with two people over the telephone and two relatives over the telephone.

All of the people spoken with told us that their care was personalised to their needs and that their privacy, dignity and independence was respected. For example, one person said, “They encourage me to do as much as I can for myself, I am now doing my shopping over the internet”. Another said, “Once I am in the bath they leave me so I can wash myself in private”.

Most people that we spoke with could not recall if they had been given information about how to make a complaint. However, they told us that they felt safe and if they had concerns they would speak with a family member or the manager. One person said “I am confident enough with the service to express views both good and rarely bad experiences”.

Another said “If I am unhappy with my plan I can talk to the manager as I have done in the past”.

Although most people could not recall being given information about how to complain we noted that the people we visited in their own homes had a copy of the agency’s brochure that included this information.

Although people were generally happy with the service they received we found that they were not formally consulted about the quality of the service. When we asked people if the agency actively sought their views about the service they received one person said, “The manager does ask us, not sure if she writes it down”. Another said “I have not been asked but my cousin checks up regularly”.

We also found that some staff were not up to date with relevant training courses and staff were not receiving formal support to discuss and monitor their work.

The inspection was announced and took place on 28 May and 04 June 2015.

Allen Auxillary Limited was last inspected on 25 April 2014 where we found that the registered person did not have quality assurance systems that included obtaining the views of people and for analysing accidents and incidents. This was in breach of regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following this inspection, we asked the provider to take action to make improvements to accident procedures and obtaining formal feedback from people who received a service and this action has been completed. The registered manager sent us an action plan that detailed steps that would be taken to achieve compliance. At this inspection we found that the registered manager had introduced questionnaires in order to obtain formal feedback from people and revised the accident reporting procedures.

Allen Auxillary Limited is a small domiciliary care agency that provides personal care and support to people in their own homes in Chichester and the surrounding area. People who were receiving a service included older people, some of whom had age related health conditions and two people who had learning disabilities. At the time of this inspection the agency was providing a service to 17 people. One of these people was in hospital when we visited the agency and as such their visits had been suspended. Visits ranged from 15 minutes to two hours. The frequency of visits ranged from one visit per week to four visits per day depending on people’s individual needs.

During our inspection the registered manager was present. 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.

Records were in place to ensure people received a safe and consistent service. However, these at times, were basic in content and the registered manager had difficulty locating some of them. The registered manager spent most of her time carrying out care duties. She explained that she found this most rewarding. She had support from her family with regards to administration and records but further work in this area is required to ensure management of the agency was robust.

People who received a service said that care workers obtained their consent when providing care and support. Care workers had received training in the Mental Capacity Act (MCA) 2005 and associated legislation. However, there were no formal written policies and procedures in place that would guide care workers if they thought a person lacked capacity to consent.

People who received a service from the agency felt safe and their risks were assessed and managed safely by staff. Care workers knew how to recognise potential signs of abuse and what action to take if they suspected abuse was occurring. They had been appropriately trained. Staffing levels were sufficient to meet people’s needs and there was flexibility that allowed for changes to people’s visit times if required. People’s medicines were managed safely and care workers were trained in the administration of medicines.

People were supported to eat and drink in line with their individual needs. The agency supported people to access healthcare professionals when needed. Care workers underwent an induction programme and received training that helped them support people who lived in their own homes. They received regular supervisions and annual appraisals from the registered manager.

People were supported by kind and caring staff. People were involved in expressing their views and were treated with dignity and respect. They were encouraged to be independent based on their individual needs. A complaints procedure was in place that enabled people to raise concerns.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.