This inspection took place on 22 June 2017. The inspection was announced. The provider was given two days’ notice of our inspection. This was to ensure the registered manager and staff were available when we visited the agency’s office.

At the last inspection in May 2015 the service was rated Good. At this inspection we found the service remained Good.

Almond Care is a small domiciliary care agency which provides nursing and personal care for people in their own homes. Some people received support for a few hours each week, and some people received support 24 hours a day. On the day of our inspection visit the agency was providing support to 21 people.

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. There was a registered manager in place at the time of our inspection visit. The registered manager was also the provider of the service. We refer to the registered manager as the manager in the body of this report.

Staff understood their responsibilities to protect people from the risk of abuse. The manager checked staff’s suitability for their role before they started working at the service. The manager made sure there were enough staff to support people safely. Medicines were administered and managed safely.

Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks to people. Care was delivered based on the individual needs of each person. People and their relatives were included in planning how they were cared for and supported, and people were supported by a consistent staff team who had the skills to meet their needs.

The provider, manager and staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards, and people’s rights were protected in accordance with the Act. Staff offered people choice and respected their decisions.

People were supported to eat and drink and were referred to healthcare services when their health needs changed. Staff were well trained and could meet the complex needs of people they cared for.

Staff knew people well and respected their privacy and dignity. People told us they knew how to make a complaint if they needed to. The manager had procedures in place to respond to complaints in a timely way, and to monitor the outcome of complaints.

The manager and provider checked the quality of the service and acted to continuously improve it; people and their relatives were encouraged to share their opinions about the quality of the service which were listened to.

This inspection took place on 21 May 2015. The inspection was announced. The provider was given three days’ notice of our inspection. This was to ensure the registered manager was available when we visited the agency’s office, and staff were available to talk with us about the service. At the last inspection in November 2013 we found there were no breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008.

Care Services is a small domiciliary care agency which provides care for people in their own homes. Some people received support through several visits each day, some received support for a few hours each week, and some people received support 24 hours a day. On the day of our inspection the agency was providing support to 15 people.

A requirement of the provider’s registration is that they have a registered manager. 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 there was a registered manager at the service. We refer to the registered manager as the manager in the body of this report.

People and their relatives told us they felt safe using the service and staff treated them well. Staff understood how to protect people they supported from abuse. People and their relatives thought staff were kind and responsive to people’s needs.

The management team carried out regular checks on care staff to observe their working practices and to ensure records were completed accurately. There was an out of hours on call system in operation, this ensured management support and advice was always available for staff.

Staff were well trained and could meet the complex needs of people they cared for.

Management and staff understood the principles of the Mental Capacity Act 2005 (MCA), and supported people in line with these principles. Where people had been assessed as not having capacity, best interest decisions had been taken on their behalf.

People told us they knew how to make a complaint if they needed to. They were confident that the service would listen to them and they were sure that their complaint would be fully investigated and action taken if necessary.

Staff, people and their relatives felt the management of the service was open. Positive communication was encouraged and identified concerns were acted on quickly.

There were procedures in place to check the quality of care people received, and where systems required change the provider acted to make improvements.

We spoke with three people that used the service who were all very happy with the service they received. One person told us “It is a good service”. Another person told us “I am very happy with the service”.

We spoke with the relatives of two people that used the service who told us they were satisfied with the service their relative received. We spoke with two members of staff that both felt well supported in their roles.

We found that the manager or deputy manager of the service carried out an initial assessment of people’s needs and put together a care plan with people to ensure their needs were met. We found that where risk associated with people’s care had been identified that control measures had been put in place.

We found that the service had a detailed safeguarding policy in place and where appropriate the service had made safeguarding referrals. We found that the provider carried out quality assurance questionnaires to ensure people were satisfied with the care they received.