This announced inspection took place on 11 April 2017. Blay Domiciliary Services provides support and personal care to people living in and around Derby. At the time of our inspection there were 85 people using the service, many of whom were living with complex health conditions or dementia.

We last inspected this service in March 2016 and rated the service as good overall.

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 were supported by staff who understood the risks people faced and knew how to make people feel safe. Risk assessment records required further development to ensure they were accurate and included measures to reduce the risk of harm. Staff had good knowledge of how to identify abuse and the action to take if abuse was suspected.

People were supported by a sufficient number of staff which helped to keep them safe and meet their needs. Staff were recruited using a thorough recruitment procedure which was consistently applied.

People who required support to take their medicines received assistance to do so when this was needed.

People were supported by staff who were suitably trained and supported to meet their needs. People's rights to give consent and make decisions for themselves were encouraged. Further work was needed to ensure records reflected people's legal rights were protected in line with the Mental Capacity Act 2005.

People were supported to have sufficient to eat and drink. Staff understood people's health conditions and provided appropriate care and support to enable people to maintain their health and well-being.

People were treated with compassion and respect. People were able to say how they wanted their care to be provided. Staff recognised and upheld people's right to privacy and dignity.

People's needs were assessed. Care plans were person centred and were regularly reviewed. Care plans were not always sufficiently detailed to provide staff with the information and guidance to meet people's needs.

Some people experienced late calls and which had an impact on their care which was not always provided in a timely way. The registered manager had identified appropriate action to resolve this.

The provider had a complaints procedure in place that supported people to share their concerns and make complaints. People and their relatives confirmed they felt comfortable to raise concerns and complaints about the service.

There were comprehensive systems in place to monitor the quality of the service and identify where improvements were needed. People and staff were able to express their views about he service. The registered manager was committed to developing and improving the service to ensure people received quality care.

The inspection took place on the 26 April 2016 and was announced. The provider was given 24 hours' notice because the location provides domiciliary care and we needed to be sure that someone would be at the office.

Blay Domiciliary Services is a domiciliary care service providing care and support to people living in their own homes. The office is based in the city of Derby and the service currently provides care and support to people living in Derby and surrounding areas. At the time of our inspection there were 116 people using the service.

Blay Domiciliary Services had 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 told us they felt safe with the staff and the support they received. Staff knew how to recognise signs of abuse and who to raise concerns with. People had assessments which identified actions staff needed to take to protect people from risks associated with their specific conditions, although some of these needed to be improved with additional information. People were supported to take their medicines as prescribed.

People confirmed that staff usually stayed for the time allocated for the call but some people told us that staff were often late for the call. People were not always notified that carers were running late. People knew how to make a complaint and most people found the service to be approachable and responsive to their concerns. A small number of people felt that the service did not listen or act upon their concerns.

The provider regularly sought the views of people who used the service and their relatives. People told us they were happy with how the service was managed overall. Some people felt that office staff were not approachable and could be abrupt at times.

People were supported by the number of staff identified as necessary in their care plans to keep them safe. There were robust recruitment and induction processes in place to ensure new members of staff were suitable to support the people who used the service.

Staff had the skills and knowledge to ensure people were supported in line with their care needs and best practice. There was effective communication between office staff and care staff and regular supervisions which supported staff to meet people's needs.

People made decisions about their care and support needs. Staff sought consent before they supported people and showed respect for people's choices and decisions. People's plans of care reflected the support they required and promoted people's independence.

Where necessary, people were supported to eat and drink and access other health care professionals in order to maintain their health.

People told us they were happy with the support they received and had developed positive relationships with staff. People found the staff to be kind and caring. Staff understood their role in supporting people to maintain their privacy and dignity. Staff were knowledgeable about the needs of people and took into account their preferences. The provider had plans to develop the format of people's care plans to ensure care was provided in a person-centred way.

The provider had established processes for monitoring and developing the quality of the care people received. These included observations of working practices and audits on care records.

We received positive feedback overall about the care and management of the service from social workers who had been involved in commissioning services for some people who used the service. They confirmed that they received occasional complaints from people using the service around late calls but had not received any complaints about the quality of the care the service provid

The inspection was completed by a single adult social care inspector. On the day of the inspection the service was provided to 94 people. As part of this inspection we spoke with seven people who used the service and three relatives. We spoke with the operations manager and trainee manager. We spoke to three care staff. We looked at five records and reviewed records relating to the management of the service. We looked at four staff records.

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. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

Risk assessments were in place for things such as moving and handling and the workplace environment. Control measures had been put in place. This meant that people’s needs were met and people were kept safe. People and their relatives confirmed they felt the service was safe. One person said, “Yes I feel safe, staff treat me with consideration and respect. Another person said, “Yes, I feel very safe.”

Documented procedures were in place for the Mental Capacity Act 2005. We were not able to see any mental capacity assessments or best interest decisions on day the day of inspection. This was because the people whose records we looked at were thought to have capacity. Staff had received training in the Mental Capacity Act 2005. This meant that systems were in place to safeguard people as required.

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff had been trained in safeguarding vulnerable adults and knew what to do in the event of suspected abuse.

Recruitment practice was safe and thorough. Disciplinary procedures were in place along with systems for staffs return to work following absence. This was to ensure people’s safety was maintained. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Is the service effective?

People experienced care and support that met their needs. People told us how they were supported. The trainee manager told us they worked with other agencies to ensure people’s health and social care needs were met. One person said, “The staff cope very well with me.” One relative said, “The occupation therapist came out to assess how staff showered X.” People confirmed that they were involved in decisions about their care. This meant that people received care in the way they wanted.

Regular audits and checks took place. Issues identified were acted on. This meant the service had effective systems in place to identify improvements and continually meet people’s needs.

Is the service caring?

People were supported by kind and considerate staff. Staff we spoke with told us how they supported people. People and relatives confirmed staff were caring, respectful and polite. One person said, “Yes the staff are very good and very caring.” Another person said, “Yes the staff are very caring. It is a very good service.”

People’s preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. People were involved in their day to day care and were supported to maintain their independence. One person said, “Staff always ask me what I want help with.” A member of staff told us that they gave people choice. They gave an example of asking the person if there was enough butter on their toast or if they would like more. People and their relatives told us they were always treated with respect and consideration. This meant people’s diversity and individuality were promoted and respected.

Is the service responsive?

People were treated with respect and dignity by the staff. This was confirmed by people we spoke with. Care plans had been developed that took into account people’s needs and wishes. These were reviewed regularly. People told us they received the same group of care staff which provided continuity. Staff demonstrated a good understanding of people’s needs.

People were given choices and supported to make decisions themselves. All people we spoke with were happy with the care they received. However a few people commented that communication could be improved when staff were running late. One person said, “If someone cannot come they get someone else.” Another person said, “Yesterday there was a crisis on a previous person’s call but no one rang me to let me know.” Another person said, “They always ring me if they are going to be late.”

People told us they would contact the office if they were unhappy about anything. We saw a copy of the complaints procedure. The trainee manager told us that a copy of the complaints procedure was kept in the care file in people’s homes. This was confirmed by people we spoke with. The trainee manager told us there had been no complaints since the last inspection.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. This was confirmed by records we saw. Staff told us they felt supported and said that the training opportunities were good. Staff were aware of their roles and responsibilities and had opportunities to raise any issues or concerns. People we spoke with were positive about the service and care they received. People confirmed they thought the service was well led.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. People’s views were gained and people had access to a copy of the complaints procedure. This reduced the risks to people and helped the service to continually improve.

The service had a quality assurance system in place. Audits were undertaken regularly. We saw records of home visits and home assessments that audited all aspects of the service. This meant the quality of the service was able to continually improve.

We spoke with six people who used the service and one relative. People told us they are able to express their views and were involved in making decisions about their care and treatment. People told us they had been given the opportunity to discuss their care needs when they first started to receive a service. People told us care workers always respected their privacy and dignity.

People told us they were pleased with the service they received. One person told us “The girls are very good.” Another said “They are all very nice and do a good job.”

People told us the same care workers usually visited them, and they felt this was beneficial as the care workers knew how to care for them.

People told us they would contact the office and discuss any issues with the office manager. They were confident that she would sort any issues for them.

We spoke with people who use the service and their relatives. They told us they felt staff treated them with dignity and respect and helped them maintain their independence.

People told us they were happy with the care they received. One person said “The staff are lovely, they are so kind and caring”. People told us they had a good relationship with care workers and were kept informed of any changes. We were told staff arrived on time and stayed for the agreed time period. If their regular care worker could not attend they were informed in advance. People told us “they are very rarely late, but if they are someone from the office rings to let us know”.

No one we spoke with had experienced any difficulty receiving medication and all felt care staff were well trained and competent to administer medications safely. People felt enough staff were available to meet their needs and that those staff were well trained and supported.

People and their relatives told us they felt they could raise a concern with the provider and were confident it would be dealt with. Everyone we spoke with told us they had the opportunity to feedback their opinions of the service and could raise an issue. One person told us “I could ring the office and they would deal with it straight away”