We inspected this service on 23 June 2016. The inspection was announced. The service is registered to deliver personal care in people’s own homes, and provides a 24-hour assisted living service and ‘social-visits’ service.

The provider was also the registered manager for the service. 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, two people were receiving a social-visits service, which is not regulated by the Health and Social Care Act (2014), and one person was receiving the assisted living service, which is covered by the Act. The person was not able to speak with us, because of their complex needs, but a close relative spoke with us as the person’s representative.

The relative told us the person felt safe, because they had known the registered manager for more than 15 years and trusted them. The registered manager delivered hands-on care to the person with the support of a team of trained staff. The registered manager had taken measures to minimise risks to the person’s safety. Staff were trained in safeguarding and understood the action they should take if they had any concerns that the person might be at risk of harm. The registered manager checked staff’s suitability to deliver personal care in people’s own homes during the recruitment process.

Care plans included risk assessments for the person’s health and wellbeing and explained the actions staff should take to minimise the identified risks. Staff understood the person’s needs and abilities by reading the care plans and shadowing experienced staff when they started working for the service.

The registered manager assessed risks in the person’s home and advised staff of the actions they should take to minimise the risks. The medicines policy included training staff and checking that the person was supported to take their medicines as prescribed by their GP.

Staff received training and support that enabled them to meet the person’s needs effectively. Staff had opportunities to reflect on and improve their practice and to consider their own career development.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The person was supported by their family and healthcare professionals to make decisions. Staff understood they could only care for and support the person with the person’s consent.

Staff sought advice from healthcare professionals when the person’s health needs changed and supported the person to follow the health professionals’ advice.

The registered manager had recorded the person’s preferences, likes and dislikes in their care plan to make sure the whole staff team knew them. Staff supported the person regularly so they knew the person well. The registered manager regularly delivered hands-on care, so they maintained an on-going relationship with the person and oversight of staff's practice.

The relative told us all the staff were kind and respected the person’s privacy, dignity and independence. They said the care staff felt more like friends or a second family, than staff.

The complaints policy was explained in the service user guide, but no complaints had been made. The registered manager encouraged the person and their relative to share their opinions about the quality of the service while supporting the person and through regular phone conversations with the relative.

The whole care team shared common values about the aims and objectives of the service. The person was supported and encouraged to live as independently as possible, according to their needs and abilities.

The registered manager and all the staff tol

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions. Below is a summary of what we found. At the time of our inspection there were two people using the service and we reviewed both of their records.

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

Is the service safe?

We saw the service provided training on infection control to staff. Staff understood their roles in relation to infection control.

We saw the service carried out Disclosure and Barring Service (DBS) checks on all staff who worked in the service to ensure they were suitable to work in the care sector.

People were supported by staff who had the knowledge and skills to deal with foreseeable emergencies. They had received first aid training which was regularly updated.

The registered manager was able to explain how the Mental Capacity Act and how this related to their service.

Is the service effective?

People’s social, health and support needs were assessed with them, and they were involved in reviewing their care plans. People told us the service met their identified needs. One person we spoke with said, “The service fully meets my needs.”

Is the service caring?

People were supported by kind and attentive staff. Staff were able to explain how they supported people to maintain their dignity and deliver services in a caring way. Care plans included details of how people liked to be supported. People told us the staff were, “Attentive” and, “ Warm”. One person said, “(Staff member’s name) is such a nice young person, I was initially uncomfortable with the idea of getting someone to help me but I am now very happy with the service provided.”

Is the service responsive?

We saw that the service had a system in place to respond to complaints and comments. The service had asked people’s view of the service and responded to what people told them. The records we read showed that people needs were assessed before they were signed up to the service. The records showed the service supported them to access activities that were important to them. We saw that checks were made to ensure people had not changed their minds about what they liked to do.

Is the service well-led?

The registered manager was clear about the aims and objectives of the service and checked what people thought about the service. We saw that the service had responded to feedback from people and staff.

During our visit we spoke with the manager of Anthony James Care Limited. Following our visit we spoke with three relatives of people to obtain their views of the service. We also spoke with two care workers.

People’s representatives told us they were involved in their care and treatment decisions of their family member. They said they were happy with the care provided.

We saw care plans for two people who used Anthony James Care. The care plans contained important information about people the service looked after.

Comments from relatives of people who received a service included, “They look after mum really well” and “I am really pleased with the care.”

People told us they felt their relative was safe and would make a complaint if it was

necessary.

The service had systems in place for recruitment of care staff and we saw checks had been undertaken to ensure staff were suitable to look after people safely.

We found the service had systems in place monitor the quality of service provided.