This inspection took place on the 22 November 2016 and was announced. We told the provider two days before our visit that we would be coming. At our last inspection in October 2014 the service was meeting the regulations inspected.

Care 4 U Ltd is a domiciliary care agency that provides personal care to older people in their homes. On the day of our inspection there were 20 people using this service.

The service had a registered manager who had been in post since the service opened in 2011. 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’s needs were assessed and care plans were developed to identify what care and support people required. People said they were involved in their care planning and were happy to express their views or raise concerns. When people’s needs changed, this was quickly identified and prompt, appropriate action was taken to ensure people’s well-being was protected. People had a copy of their care plan in their home.

People felt safe. Staff understood how to recognise the signs and symptoms of potential abuse and told us they would report any concerns they may have to their manager. Assessments were undertaken to assess any risks to the people using the service. The risk assessments we viewed included information about action to be taken to minimise these risks. However we found that environmental risks, to protect staff were not in place. Soon after the inspection, a proforma to capture environmental risks had been put in place.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

We found that the service was working within the principles of the MCA.

Staff were highly motivated and proud to work for the service; as a result staff turnover was kept to a minimum ensuring that continuity of care was in place for people who used the service.

Staff were very complimentary about the management team and described them as approachable and supportive.

Staff were respectful of people’s privacy and maintained their dignity. Staff told us they gave people privacy whilst they undertook aspects of personal care, asking people how they would like things done and making enquiries as to their well-being to ensure people were comfortable.

Care staff received regular supervision and appraisal from their manager. These processes gave staff an opportunity to discuss their performance and identify any further training they required. Care workers we spoke with placed a high value on their supervision.

We saw that regular visits and phone calls had been made by the office staff to people using the service and their relatives in order to obtain feedback about the staff and the care provided.

People were supported to eat and drink. Staff supported people to take their medicines when required and attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

The service had a complaints policy. People who used the service told us they knew how to make a complaint if needed.

The five people we spoke with were very positive about the care and support provided by Care 4 U Ltd. Typical comments were “very satisfied” and carers were described as “supportive and considerate”. People spoke very positively about the care and support they received from the service. One person’s comments were typical when they told us that “I am happy with the service I am getting.”

People told us that they understood how to raise concerns with the service. One person said, "I don’t have any concerns, but the manager contracts me regularly and I know he would deal with anything that troubles me." They said that someone was always available at the office when they called, and that the staff would listen to them.

There were effective recruitment and selection processes in place. We checked that recruitment procedures were being followed appropriately so that unsuitable staff were not employed at the service. People said that staff were, “reliable”, “helpful” and “efficient”. One person’s comments were typical when they told us, “my carer does a good job in helping me”. We reviewed the personal files of five members of staff. People who use the service confirmed that regular checks were carried out by the agency to make sure that people received the quality of care they expected. They were happy with the service and they confirmed they felt consulted.

The three relatives spoken with were very positive about the care and support provided by Care 4 U Ltd. One relative's comments were typical when she said, "the carers are very good and understanding." Another relative said, “the care we receive is excellent.” Relatives told us that they understood how to raise concerns with the service. They said that someone was always available at the office when they called, and that the staff would listen to them.

Relatives told us they felt staff understood the needs of the people they supported. People's personal records including their care plans were accurate. Care plans had been reviewed and updated at regular intervals. Records were kept securely and could be located promptly when needed.