This announced inspection took place on 4, 10 and 11 October 2017. The provider was given short notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

Ark Nursing and Care Agency provides nursing and personal care to people in hospitals, care homes and to people who need assistance in their own homes. At the time of our inspection there were 13 people receiving a service in their own homes.

At the last inspection in September 2015 the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

The service continued to provide safe care to people. One person commented: “I feel safe with the carers.” Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.

There were effective staff recruitment and selection processes in place. People received effective care and support from staff who were well trained and competent.

Staff spoke positively about communication and how the registered manager worked well with them and encouraged their professional development.

A number of methods were used to assess the quality and safety of the service people received and made continuous improvements in response to their findings.

We arranged our visit with the agency the day before the inspection to ensure arrangements could be made for us to talk with people and staff.

We asked staff how they ensured people gave consent to their care. One care assistant told us “I always offer people a choice; I never take things for granted. We can give people advice and make suggestions but we can’t tell people what to do. The final decision is theirs as long as they are safe and well”.

One person we spoke with said “I have had support for two to three years, there are three or four people that cover the whole of the week. I look forward to seeing the same people on the same day. My care plan was drawn up with my daughter, they seem to take notice of what you are saying, and they are on the ball. I generally feel in control”.

Staff we spoke with had experience of working with other agencies that worked alongside Ark to provide care. They were clear about their responsibilities in this type of situation. One care assistant told us that “my role is the main carer and it is our care plan that we work to. If the family have any issues or concerns they contact Ark first”.

One care assistant told us “I have clarity about my role. This is because I have lots of training and go to imparting knowledge information days. The training days are very helpful”.

A case manager we spoke with told us that “If I have any concerns I ring up the agency, there is a good relationship, they are open and transparent”.

People we spoke with who currently use the agency and where appropriate their next of kin told us that they found the care staff very supportive and helpful. Everyone said they were satisfied with the care received and the manner in which it was delivered by staff. Comments included: “X’s needs are being absolutely met. Would not be able to keep X at home if it wasn’t for the support from the agency staff”, “The staff team are good and consistent”, “The staff and care provided is absolutely brilliant, first class” and “The staff follow X’s care plan properly.”

People we spoke with who received a service from the agency said that their care and welfare needs were well met. People told us that staff supported them appropriately with daily living tasks, including personal care and meeting nutritional needs.

People we spoke with confirmed that they felt safe and supported by staff from the agency. They had no concerns about the ability of staff to respond to safeguarding concerns.

Staff were able to speak confidently about the care practices they delivered and understood how they contributed to people’s health and wellbeing.

People were made aware of the complaints system. This was provided in a format that met their needs.

This inspection took place on 7, 14 and 15 September 2015 and was announced. The provider was given short notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

Ark Nursing and Care Agency provides nursing and personal care to people in hospitals, care homes and to people who need assistance in their own homes.

When we visited there was a registered manager in post. 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 felt safe and staff were able to demonstrate a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate processes.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. They were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the right care and treatment.

Staff relationships with people were strong, caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.

Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately. Staff spoke positively about communication and how the management team worked well with them, encouraged team working and an open culture.

A number of effective methods were used to assess the quality and safety of the service people received.