C and S care services is a domiciliary care agency which is registered to provide personal care to people living in their own homes. At the time of our inspection they were providing personal care to 204 people. At the last inspection, the service was rated as good. At this inspection we found the service remained Good.

People told us they felt safe and staff knew how to manage people’s risks. There were sufficient staff to meet people’s needs and people received their medicines as prescribed.

Staff were well trained which meant people received effective care. People who received support with their nutritional needs told us they had choices in what they ate and staff respected them. Staff knew what to do should people require support from other healthcare professionals.

People and their relatives were enthusiastic about the care they received and told us staff were always kind and considerate. People told us staff respected their privacy and dignity and supported them to remain independent where possible.

People and their relatives told us they were supported by staff who knew them well and could therefore respect their choices in how they preferred to have their care delivered. There was a complaints system in place should people wish to comment on their care.

People, their relatives and staff all told us the service had good leadership and wouldn’t hesitate in recommending the service to others. Staff told us they were supported in their roles by the management structure in place. There was a quality assurance system which meant the quality of the care people received was constantly being reviewed and improvements made where necessary.

The inspection took place on 19 May 2015. At the last inspection in October 2013 the service was not meeting the regulation around the safe management of medicines. We saw that the provider had completed the actions from their action plan after the inspection and they now met the requirements of this regulation.

The service is a domiciliary care agency, providing care for 245 people in their own homes at the time of our inspection and employs 106 staff at this location. There was a 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.

People were protected from harm and abuse by staff who had a good understanding of how to protect people. The staff members we spoke with all knew the different types of abuse and were confident in the processes to report any concerns or abuse they have witnessed. People had clear risk assessments that detailed the risks to them with guidance for staff to follow to make sure people were kept safe. There were enough staff to provide people with safe care.

People’s medicines were managed safely. Since our last inspection the provider had developed new systems to safely record and administer people’s medicines to support their health needs.

People were supported by staff who were well trained and supported in their work. Staff had completed training, which the provider considered to be essential training and were able to request additional training. They received regular supervision and support from their managers. This made sure staff had the skills and support they needed to support people safely and effectively.

People were asked for their consent for care. We saw that people’s views and consent for care were sought and care and people’s rights and freedoms were respected.

People were supported to maintain a balanced diet and were given the food and drink they needed. We saw that people were given choices about their food and were happy with the support they received. People’s health was monitored and the provider worked with other services involved in people’s care to make sure they received the correct care.

Staff members had caring relationships with people who used the service. People had regular carers who knew them well and understood their needs and preferences. Care workers involved people in making decisions about their care and supported people to maintain their independence. People’s privacy was respected by care staff who made sure they maintained people’s dignity when providing them with personal care.

People had care plans that were tailored to meet their individual needs. We saw care plans were regularly reviewed and updated to reflect people’s changing needs and preferences. The care plans had personal information and details of people’s backgrounds and detailed the ways that people wanted to receive their care. People told us these care plans were followed by staff and they received the care they needed.

The provider had a clear complaints procedure and people felt confident in raising any concerns or making a complaint about the service. Complaints were dealt with in the timescale set out within the policy and we saw examples of feedback given to people following complaints and suggestions.

The service had an open culture that supported people and staff to talk about their experiences of the service and encouraged people to give their feedback and ideas for improvement. Staff were involved in regular team meetings and given the support they needed to increase their skills and confidence in providing good care. The registered manager had a visible presence in the service and was approachable for staff, people using the service and their relatives to discuss their care and service received.

The provider had a quality assurance system in place to audit and monitor the quality of the service. We saw details of regular audits of care files and staff files, and an annual survey was completed with the results of the survey being sent to people using the service.

C & S Care Services were providing care and support to over 400 people at the time of our inspection. We carried out telephone interviews with 10 people who received services, and seven relatives. We visited the office and spoke with five care workers, the manager, and the provider who supported us with the inspection of this agency.

People and the relatives we spoke with confirmed they had been involved in making decisions about the care and support they wanted to receive. One person told us, “I had an assessment completed and I told them what support I needed, this is what is in my care plan which I have signed and agreed.”

The people we spoke with confirmed their privacy, dignity and independence were respected by the staff that supported them. One person said, “The staff are very good and I am very happy with what they do.” Another person told us, “They provide the support I need them to and they always ask me what I want.”

We found that people where happy with the way their medication was administered. However, improvements were required with the records related to medicines.

Care workers we spoke with told us they felt supported by the management team. They confirmed they had regular training opportunities to help them deliver care to an appropriate standard.

We found that systems were in place for assessing and monitoring the quality of service provided.

We carried out this inspection to check on the care and welfare of people. We spoke with six people, five relatives, four staff, and the deputy manager.

We found that people were asked for their consent before care was delivered. One person said, “They know my needs and preferences, but they still ask.”

People we spoke with told us they received care that met their needs. One person said, “They do everything I have asked for.”

We found that arrangements were in place to ensure that people were safeguarded from harm.

We found that selection and recruitment processes were robust to ensure that only suitable staff were employed to work with people.

People's comments and complaints were taken seriously. One relative told us, “I complete the surveys they send out, but I have nothing but praise.”

We carried out this review to check on the care and welfare of people using this service.

We visited the office and spoke with the managers and five members of staff. We had telephone conversations with one person who used the service, the relative of another person and two care workers.

We looked at the care packages and documentation, which were kept at the office, of the people who used the service and who we spoke with. We saw regular reviews of care were completed and contact with people was recorded. People told us they were fully involved in making decisions about their care and how the care was provided. They told us “The staff are very good; they are very efficient, friendly and helpful”.

We saw the way the service monitors the frequency and times of the arranged calls. One person told us that staff “arrive at the time that is arranged”. They went on to say in the event of the carer being late or any changes needed to the expected carer the ‘office’ always rings and informs them.

Staff told us they felt the training provided was sufficient for them to do their job effectively and efficiently. They told us they were able to suggest subjects for further training that they felt was relevant to the care they provided. People who used the service told us they felt the staff were competent in providing the care.

We saw the way the service monitors the quality of the service. People are given the opportunity to comment through satisfaction surveys that are distributed every six months. We saw a report that had been produced following a recent survey. We saw many positive comments regarding the staff and the service. One person we spoke with told us that they were very satisfied with the complete care package.