We inspected the service on 13 October 2016. The inspection was announced. The provider was given 48 hours’ notice because the location provides domiciliary care; we needed to be sure that someone would be in.

Always Take Care provides 24 hour care to people in their own homes. On the day of our inspection the service was supporting 38 people.

The service had 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.

People told us that they felt safe. Staff were aware of their responsibility to keep people safe. People received their medicines as required. Medicines were administered safely by staff who were appropriately trained and competent to do so.

Risks were assessed and managed to protect people from harm and staff understood what to do in emergency situations.

Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported and that communication between themselves and senior staff was good. Safe recruitment practices were being followed.

People’s nutrition and hydration needs were assessed and met. People’s health needs were met and when necessary, outside health professionals were contacted for support. People’s health records were being maintained.

People made decisions about their care and the support they received. People were involved in reviewing their care and their opinions sought and respected. The registered manager understood their responsibility to ensure people were supported in line with the Mental Capacity Act 2005 (MCA).

People were involved in the planning and implementation of the care that was provided. Staff checked with people that the care that they provided was to their liking and met their needs.

Dignity and respect for people was promoted. People’s independence was promoted and people were encouraged to make choices. Staff treated people with kindness and compassion. People were supported to practice their religion as they wished.

The care needs of people had been assessed. Staff had a clear understanding of their role and how to support people who used the service. People contributed to the planning and reviewing of their care.

People and staff felt that the registered manager was approachable and action would be taken to address any concerns they may have. People and staff were kept informed of changes to the service and their feedback was sought.

There were a range of audit systems in place to measure the quality and care delivered so that improvements could be made. The registered manager was aware of their responsibilities.

During our inspection we spoke with one person who used the service, to three relatives and one member of staff.

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

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People told us that they felt their rights and dignity were respected. One person said "The level of care is very good, they are here for you”. A relative said “The care provided to my parent is fantastic, they make sure they are involved and included”

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Staff knew about risk management plans and told us about how they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

Policies and procedures were in place about all aspects of service provision.

The provider ensured that staff rotas where planned so that people's care needs were taken into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were always met. People had their needs assessed before they began using the service. People's needs were assessed by experienced staff.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in

writing their plans of care. Care plans were reviewed every six months or sooner if required. People who use the service, their relative sand staff could contact the provider at any time and frequently did so. Any changes were responded to with a visit by the provider and reassessment of needs.

People said that their care plans were up to date and reflected their current needs.

One person said "They have helped me to improve, I am almost ready to go solo”.

All staff received induction training and annual training updates. A staff member we spoke with was extremely knowledgeable about the person’s needs and preferences. They knew about the person’s preferences and also described how they worked closely with the community nursing team and GP.

Is the service caring?

We spoke with one person who used the service and to three relatives. We asked them for their opinion about the staff that supported them. Feedback from people was positive, for example; "The level of love and attention is good” and "The level of caring is very good, they are here for you”

When speaking with staff it was clear that they genuinely cared for the people the person they supported. They also described how caring the provider was and told us they always acted quickly to respond to people’s changing needs.

Is the service responsive?

People knew how to make a complaint if they were unhappy. People told us they could contact the provider at any time and had their care and support needs reviewed at least every six months. We were given examples of how the provider had acted quickly and appropriately in response to changing need and to issues of concern. A staff member also confirmed that this was the case.

At the time of our visit there was no one from an ethnic minority community using the service. We were told that written information could be translated into other languages and that people’s cultural and religious needs were considered as part of the assessment process.

Is the service well led?

The provider had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

Staff were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.