Cambridgeshire Care Agency Limited is a domiciliary care agency (DCA) providing the regulated activity of personal care to people who live in their own homes. At the time of this inspection one person was receiving support with their personal care from the agency.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this announced inspection carried out on the 10,11 January 2019, we found the service remained Good overall.

Staff protected people as far as possible from discrimination and harm. The registered manager assessed potential risks to people. Plans were in place so staff knew how to minimise risks to people in the least restrictive way and without removing people’s right to take risks. However, staff did not always notify the registered manager quickly enough when people’s care and support needs changed.

The registered manager recruited new staff following checks to make sure they were suitable. There was enough appropriately trained staff to work in this service to meet people’s changing needs. Staff did not support people with their prescribed medication. Staff had received training in infection control practices. Staff had personal protective equipment such as gloves and aprons provided for them. The registered manager and staff team used incidents as a learning tool to help further ensure people’s and staffs safety and well-being.

People continued to receive an effective service. Staff received supervisions, appraisals, training and support, which helped them to do their job. The registered manager assessed people’s care and support needs to make sure staff could meet these needs, before offering the person a service. Staff supported people to eat and drink enough to maintain their health. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People continued to receive care and support from staff who cared about their well-being. Staff respected people’s privacy and dignity. They knew people well and helped people to still be as independent as possible.

People continued to receive a service that was responsive to their needs. People were fully involved in planning their care and made their own decisions about this support. Support plans were personalised and gave information for staff, from the person’s viewpoint. Staff went with people, if asked, to community activities and keeping their interests. The registered manager dealt appropriately with complaints and tried to resolve complaints wherever possible.

The service continued to be well-led, by a registered manager who gave good, hands-on leadership. They monitored the service for quality and put actions in place to address any shortfalls. There was an open, person-centred culture. The provider sought the views of people, and staff and these views were considered to ensure continuous improvement. The service, where possible, worked in partnership with organisations to provide people with joined-up care.

Further information is in the detailed findings below.

All of the people who use the service that we spoke with said that they were happy with the care and support they received. This was because people were treated with respect and supported in meeting their care needs, whilst maintaining their independence. One person told us that, “Staff were very polite and respectful and get on with their jobs”.

Four relatives of people using the service we spoke with were complimentary and positive about the support provided. One person commented that communication from the provider was good and said, “Any little problem they will give me a call”.

We found that people were placed at risk because there were gaps in staff training and that there was no whistleblowing process evidenced at the time of the visit.

The provider does not have adequate quality assurance systems in place to check that the quality of the service being delivered is meeting people's needs.

This announced comprehensive inspection was undertaken on 7, 11 and 12 January 2016. We gave the service 48 hours’ notice of our inspection.

Cambridgeshire Care Agency Limited is a small domiciliary care agency registered to provide personal care to people in their own homes. There were four people being supported with the regulated activity of personal care at the time of our inspection.

There was a registered manager in place during this inspection. 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. No one being supported by the service lacked the mental capacity to make day-to-day decisions. Staff demonstrated to us that they respected people’s choices about how they would like to be supported. However, not all staff were able to demonstrate a sufficiently robust understanding of MCA. The lack of understanding increased the risk that any decisions made on people's behalf by staff would not be in their best interest and as least restrictive as possible.

Plans were put in place to reduce people’s identified risks, to enable people to live as safe and independent a life as possible. Arrangements were in place to ensure that people were prompted with their prescribed medication when needed. Accurate records of staff supporting people with their prescribed medication were kept.

People were supported by staff in a respectful and caring way. Individualised support and care plans were in place which recorded people’s care and support needs. These plans prompted staff on any assistance a person may have required.

People, when needed, were assisted to access a range of external health care professionals and were assisted to maintain their health and well-being. Where required, staff supported people to maintain their links with the local community to promote social inclusion. People’s health and nutritional needs were met.

People were able to raise any concerns or suggestions that they had with the registered manager and staff and they felt listened to. Communication between people and the office staff/ management was good.

There were pre-employment safety checks in place to ensure that all new staff were deemed suitable to work with the people they supported. There were enough staff available to meet people’s care and support needs. Staff understood their responsibility to report any concerns about poor care practice.

Staff were trained to provide care which met people’s individual care and support needs. Staff were assisted with their training needs by the registered manager to maintain and develop their skills. The standard of staff members’ work performance was reviewed by the registered manager through supervisions, appraisals and spot checks. This was to ensure that staff were competent and confident to deliver the care and support required.

The registered manager sought feedback about the quality of the service provided from people who used the service. Staff were notified of any updates and changes to the service via e-mail communication. Quality monitoring processes to review and identify areas of improvement required within the service were in place. However, these audits did not always identify all areas of improvement needed regarding records held.