About the service: Astracare is a domiciliary care service providing care and support to people in their own homes. At the time of the inspection there were 250 people using the service.

People’s experience of using this service:

The service met the characteristics of good in all five key questions. Therefore, our overall rating for this service is good.

People and their relatives told us they felt safe and were happy being supported by Astracare. The provider had effective safeguarding procedures. Staff had a good understanding of abuse and felt confident raising concerns.

Risks to people were managed in a way that kept them safe. We found both environmental and individual risk assessments provided guidance for staff to keep people safe.

The provider followed safe recruitment systems. People told us the staff were reliable and they did not have any missed calls.

Medicines were managed safely, and the senior staff made sure staff were competent to administer medicines.

Staff received training in infection control and followed procedures to reduce risks for people.

People had care plans in place. The quality assurance manager ensured people’s needs were reviewed regularly. People's health and wellbeing was documented and referrals to external professionals were made when necessary.

Staff told us they had an appropriate induction and had received appropriate training to confidently carry out their role.

Staff had appropriate knowledge of the Mental Capacity Act (2005). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us the staff were caring. We saw numerous compliments about the nature of the staff. People were treated with dignity and respect.

Families knew who to speak to if they had a complaint and felt able to express concerns to staff.

Feedback from people who used the service and staff was that the service was well led. They told us the managers were approachable and were available to speak with.

The registered manager carried out audits and managed accidents and incidents appropriately. The registered manager and office manager worked well together to manage the service effectively.

Rating at last inspection: Good (November 2016)

Why we inspected: This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We carried out an unannounced inspection at Astra Care Services Limited on the 28 & 29 September and 3 October 2016. We contacted people using the service on the 29 September 2016.

Astra Care Services Limited provides personal care within the boroughs of Burnley, Pendle and Rossendale. This family run service is located in the village of Barrowford near Nelson and is staffed during office hours, with a 24-hour on call system. The service provides flexible personalised care and support for people who require additional support to live independently within the community. The service also provides palliative care for people with life threatening illness. At the time of our inspection there were 235 people receiving a service

We last visited Astra Care Services Limited on the 5 September 2013. The service was fully compliant in all areas assessed.

At the time of this inspection 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.

During this inspection we found the service was meeting the current regulations.

People using the service received care and support from a team of staff who had been carefully recruited and trained to deliver safe and effective care and support. People told us they felt safe in their homes and that staff were trustworthy. People who completed our survey told us they felt safe from abuse or harm from the staff and they were treated with respect.

People using the service and their relatives described the service as very good. They said there was and never had been any cause for concern in how they were treated. Staff were very respectful, attentive to their needs and treated them with kindness and respect when providing their support. Staff were also described as being caring and kind and willing to go that extra mile to support them.

Staff had been trained in safeguarding vulnerable people and knew what to do if they suspected any abusive or neglectful practice. Safeguarding procedures were in place to guide and direct staff in reporting any concerns they had.

Risks to people’s health, welfare and safety were managed very well. Risk assessments were thorough and informed staff of the actions to take to support people safely. People knew they could contact the agency at any time and had emergency contact details for out of office hours.

There were appropriate arrangements in place to support people to take their medicines. People received their medicines as prescribed by staff that had been trained to do this safely.

Staff knew what to do in emergency situations and had guidance around keeping themselves and people they supported safe. Good arrangements were in place for staff to gain entry into people’s homes without placing them at risk. Staff were provided with protective equipment such as disposable gloves and aprons to minimise the risk of cross infection between people they visited.

Staff were trained in the principles of the Mental Capacity Act 2005. Staff understood the principles of best interest decisions’ regarding people’s care and support and people’s diversity was embraced within their care plans. Care plans were well written and person centred and focused on the needs of people using the service. People’s right to privacy, dignity, choice and independence was considered and reflected in their care plan.

Staff felt confident in their roles because they were well trained and supported by the registered manager to gain further skills and qualifications relevant to their work. Staff were effectively supervised.

Staff had been trained in Palliative Care / End of Life Care. This meant people receiving this specialist care could be confident staff had

People told us they were satisfied with the care and support provided by Astra Care. We spoke with six people using the service and one relative. They told us, “I would give them ten out of ten”, “It’s a good reliable service”, “They are really quite good” and “There is nothing I can fault them on”.

People were being involved as far as possible in planning and consenting to their care and support and were enabled to make decisions about matters which affected them.

People told us the care they received was good and that they had care plans describing how their support should be provided.

We found arrangements were in place to safely support people with their medicines.

People told us they liked the staff who provided their care and support. They said: “All the carers are very polite and obliging”, “My carers are good, they ask what I want and they know what I need” and “They are good at what they do”.

We found people had been formally asked about their experience of the service. There were arrangements in place to check things were being done properly.

People using the service told us they were satisfied with the care and support they received from Astra Care Services. They told us, “I appreciate the support I get from Astra Care” and “It’s the best care company we have had, they deserve a badge”.

People told us they were involved in planning their care and support, they were enabled to make choices and decisions about matters which affected them. People spoken with told us they had been provided with written information about the agency.

People considered they were treated with dignity and their privacy was respected. Most people spoken with considered the agency was good with time keeping and continuity. They told us they were encouraged to be as independent as possible.

They told us the care they received was good, that they had care plans which instructed staff on what they needed to when they visited.

People spoken with had no concerns about their care and treatment, they said they felt safe with the staff. They said described staff as good and “Spot on”. They all indicated they knew what to do if they had any complaints and were confident that any concerns would be resolved.

People using the service told us they were satisfied with the support they received from Astra Care Services; they made the following comments, “We are extremely pleased with Astra, we couldn’t ask for a better team”. “Very good on the whole”. “Astra are good there is always someone who can come to help”. “Astra are the best company we have had so far”. “We are well pleased with them”. “We would recommend Astra to others, no problems whatsoever”. “I feel very fortunate to be with Astra, I feel confident with them”. “They always do as I ask and they will do extra”. “They went out of their way to get here when the weather was bad”. A relative said,“The staff are pleasant, lovely when they think things are not right they contact me, I would give them 10 out of 10 for that”.

People told us they were involved in planning their care and support, they were enabled to make choices and decisions about matters which affected them.

People considered they were treated with dignity and their privacy was respected. They told us they were encouraged to be as independent as possible.

They told us the care they received was good, that they had care plans which instructed staff on what they needed to when they visited.

People had no concerns about their care and treatment, they said they felt safe with the staff. They said the staff were good, nice and pleasant.

People said they were being consulted about the service and that checks on visits and practices were being carried out.