This inspection visit took place on 27 February 2017 and was announced.

ARC Community Care Ltd is a domiciliary care agency that provides care and support to people in their own home. This includes personal care shopping, activities and appointments to people who live in their own homes. The agency provide support to people with a range of care needs and include older people, people living with dementia and people with physical disabilities. The office base is located in a residential area of Lytham St Anne’s. At the time of our inspection ARC Community Care Ltd provided services to over 60 people.

At the last comprehensive inspection on 03 December 2014 the service was rated overall as good.

There was a registered manager in place. 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 they had been visited by senior staff before their support began who carried out an assessment of their needs. There were procedures in place to protect people from abuse and unsafe care. We saw risk assessments were in place which provided guidance for staff. This minimised risks to people.

We spoke with people who received a service. People told us they felt safe and comfortable with staff, they received attentive care and they liked the staff who supported them. They said staff were friendly and respectful, punctual and conscientious. People told us staff had never missed visiting them. They usually arrived on time and informed them if they were delayed. People told us they were usually supported by the same group of staff who they knew and liked.

Recruitment and selection was carried out safely with appropriate checks made before new staff could start working for the service. Staff had the skills, knowledge and experience needed to care for people. They received training to carry out their role and were knowledgeable how to support and care for people. They had the skills, knowledge and experience to provide safe and effective support.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). Staff had not needed to make an application when we inspected.

Staff supported people to have a nutritious dietary and fluid intake, assisting them to prepare and eat food and drinks as they needed.

Staff supported people with medicines safely. People able to manage their own medicines were encouraged to do so.

Care plans were personalised detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in making decisions about their care. Their consent and agreement were sought before providing care.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise any concerns.

Senior staff monitored the support staff provided to people. They checked staff arrived on time and supported people in the way people wanted. Audits of care records and risk assessments were carried out regularly. People and their relatives were encouraged to complete surveys about the quality of their care.

ARC Community Care is a domiciliary care agency that provides care and support to people in their own homes. At the time of the inspection there were approximately 60 people who used the service. The agency provide support to people with a range of care needs, which include older people, people living with dementia and people with physical disabilities.

This inspection took place on 3rd December 2014. The provider was given 48 hours’ notice that the inspection was going to take place. We gave this notice to ensure there would be someone available at the service’s office to assist us in accessing the information we required during the inspection.

The last inspection of the service took place on 10th December 2013. The service was found to be compliant with all the areas assessed during that inspection.

At the time of the inspection there was a registered manager at 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.

Throughout this inspection we received very positive feedback from people who used the service, their main carers and a community professional. People expressed satisfaction with the service provided and spoke highly of staff and managers. Their comments included, “I can’t thank them enough, I’m very fortunate.” “I’m quite satisfied. The people are really good.” “Please tell them how much I admire the girls, they are marvellous.” “I’m well pleased, it’s a great help.” “They’re 100%, I have no faults with them.”

People told us they felt safe when receiving care and that their care was provided with kindness and compassion. People felt their views and opinions were taken into account and that their care was based on their personal needs and wishes.

There were processes in place to ensure staff were aware of any risks to people’s safety and wellbeing and the registered manager ensured staff had the knowledge and skills to support people in a safe manner.

Staff were carefully recruited and a number of background checks were carried out to help ensure they were of suitable character to work with vulnerable people.

There was a detailed induction and training programme in place, which helped ensure care workers had the necessary skills to support people in a safe and effective manner.

The registered manager encouraged the views of people who used the service and other stakeholders. We saw a number of examples of changes and developments within the service, which had been made as a result of people’s suggestions and comments.

There was an open culture within which people who used the service and other stakeholders were comfortable to raise any concerns. People had confidence that any concerns they did raise, would be dealt with appropriately by the registered manager.

The registered manager had effective systems in place to monitor safety and quality across all aspects of the service. The registered manager ensured she kept up to date with best practice and sought to achieve constant development and improvement.

We spoke to three care staff. They were all able to explain what to do if people who used the service refused any part of their care and all were able to talk through how consent was gained from people when giving personal care.

People who used the service and their relatives told us that they were happy with the care they or their loved ones received. One person said, "I'm very happy, there are some lovely girls (care workers)". Another person said, "Yes, I'm happy,all the carers are nice and I have no issues".

People were supported by staff who were appropriately trained to deliver the assistance required by each individual.

Appropriate systems were in place to regularly assess and monitor the quality of services that people receive. Internal and external auditing systems were used.

The service had an effective complaints policy and procedure in place that both staff and people who used the service understood.

During the inspection we spoke with four people who used the service. The feedback we received was without exception, extremely positive. People told us they were very happy with the standard of care provided and spoke highly of their carers. Comments included;

‘’We have been having them for years and have never had the slightest problem!’’

‘’I would recommend them to anybody.’’

‘’We are more than satisfied with all the carers. We find them all very good.’’

We looked at a number of areas during the inspection, including how the agency promoted the care and welfare of people who used the service and how they ensured that staff were competent to carry out their roles. We found that the service was compliant with all the areas we assessed. However, we did identify some areas for minor improvement and we have asked the service to address these.

The people we spoke to during our visit told us they were happy with the care and support they were receiving. People using the agency said that staff carry out personal care with dignity and respect at all times. One person said, “Staff are polite and friendly and always do their best.” Another person said, "I couldn’t have better staff helping me".

People using the agency told us senior staff had given them information about the agency when they visited them to check what support they needed. People using the agency said they kept their care records in their home. One person said they had a special file that has everything in about their care in it. People spoken to said they were able to make any changes to their care and support easily and just had to let the office know.

We asked people using the agency about the care and support they received and were told the staff were supportive and caring. One person said, “The staff make it possible for me to stay at home and have regular checks.” Another person said, “The staff are so good. It means a lot to me to stay in my house.”

People using the service said that they usually have staff who are familiar with their care needs particularly during the week. One person said, “When it is my usual carers things go like clockwork, it is harder when the staff have to check with the book and I have to tell them what needs doing.”

Another person said the staff care for me so well, particularly when I have my regular staff, They know exactly what needs doing.”

A small number of people said that sometimes the agency were unable to provide staff or that staff arrived late but most people said staff were rarely late and if staff were going to be late they received a telephone call so that they were not ‘sat waiting’.

A small number of people felt that staff did not always arrive when they should but most people spoken to said that staff arrived on time and stayed for the length of time they should do. People using the service said that staff seemed to know what they were doing and were skilled in providing care. One person said, “The staff check everything is alright before they go.”

Most people using the service that we spoke to said they received the help and support they needed at the times they needed it. One person said, “The staff are so good, they go out of their way to help you and are so kind.” Another person said, “They make the difference between me staying here in my house or going in a home.”

Staff have to log in when they arrive and leave each person’s home so if they are late senior staff would quickly become aware of this. A small number of people had expressed concern that sometimes calls were too close together but when talking to people who received several visits a day, they were satisfied with the timing of visits and said they would tell ‘the office’ if there was a problem.

Staff spoken to said ARC was a good agency to work for and recruitment was robust with good training. One member of staff said, “I have received loads of good training here. It is really important to know what you should be doing."

People said that they had staff that they knew most of the time, but that they had staff who were not familiar with their care needs more at weekends than during the week. One person said “It is harder when the staff don’t know what to do. They just have to go off the book”.

Most people we spoke to told us they felt confident they could raise an issue of concern or complaint to the staff or managers if they felt they needed to. One person said, “I just tell the staff if there is something wrong and they help.” Another person said, “I just ring the office and they deal with any problem.”