Care Fully Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection 2 people were supported by Care Fully Limited.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. We have rated well led as requires improvement. However, the overall rating remains Good.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The registered manager is also the provider for this location.

The service was safe. The registered manager and staff member understood safeguarding and were competent to report any concerns they had. People were supported to take their medicines safely by staff that were trained to ensure best practice. There were enough staff to provide support at a time they wanted. Safe recruitment practices were in place to employ suitable staff. Staff understood the importance of good infection control and wore appropriate equipment provided to keep people safe.

The service was effective. Staff had completed training to meet people’s needs effectively. The registered manager and staff member had access to regular support and meetings. The registered manager and staff member worked in line with the Mental Capacity Act 2005 (MCA) principles, they understood the importance of promoting people’s choice. People care needs were assessed and reviewed. Staff supported people with their nutritional and hydration requirements.

The service was caring. Staff knew people well and staff cared for them in a compassionate way. Staff respected people’s privacy and dignity and supported people to maintain relationships and their independence. Staff delivered care that was supportive, kind and caring. People were involved in deciding how their care was provided.

The service was responsive. People`s needs were assessed to ensure people received the support they required. People confirmed they were involved with their care reviews. People received support that promoted their independence. People knew how to raise any concerns or complaints if required. People confirmed they received their calls at a time they wanted.

Well-led required improving. The registered manager was clear about their vision and values for the service and what they wanted to achieve. The registered manager had a good overview of the service and ensured people’s needs were met. We found that the registered manager and staff member provided the correct support and managed risks appropriately. However, documentation needed to improve. For example, care plans required better guidance on how to deliver the care and support in a way the person wanted. Risk assessments also needed more detail on how to manage the identified risks. Documents for recording accidents and incidents also required improving.

Further information is in the detailed findings below.

The inspection took place on 16 March 2016 by one Inspector and was announced 48 hours before it took place due to the nature and size of the service. This was to make sure that the registered manager, staff and people who used the service would be available to talk with us as part of our inspection. When we last inspected the service on 29 April 2014 the service was found to have met the essential standards we looked at.

Care Fully Limited is a family operated domiciliary care service that provides care and support to a small number of older people in their own homes. At the time of our inspection only one person received personal care from the service.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

At the time of our inspection only the registered manager, who also provides care and support, was available to talk with us. This was because the only other staff member employed by the service on a period of extended leave.

People told us that they felt safe and well cared for by the service. Staff received training in how to safeguard people from abuse and report any concerns they may have. Safe and effective recruitment practices were followed to ensure that staff were suitable. Sufficient numbers of staff were available to meet people’s agreed care and support needs in a timely and patient way.

Although the service did not manage or administer medicines, appropriately trained staff prompted people to take their medicines safely and at the right time. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.

People who used the service, their relatives and healthcare professionals were very positive about the skills, experience and abilities of staff who provided care and support. Staff received training relevant to their roles and had regular meetings with the registered manager to discuss the people they supported, how the service operated and issues of importance to them.

People were supported to maintain good health and to eat a healthy balanced diet that met their individual needs and preferences. The registered manager and staff always established people’s wishes and obtained their consent before providing personal care and support.

The registered manager and staff had developed caring relationships with the people they supported and clearly knew them and their needs very well. People who used the service, together with their family members where appropriate, were involved in the planning and reviews of the care and support provided.

The confidentiality of information held about people’s medical and personal histories was securely held and maintained.

Support was provided in a way that promoted people’s dignity and respected their privacy. People received care that met their needs and took account of their preferences. The registered manager was very knowledgeable about people’s background histories, preferences, routines and personal circumstances.

People felt that the registered manager and staff listened to them and responded to any concerns they had in a positive way. They knew how to complain should the need arise but told us they had never had cause to do so.

People who used the service, their relatives and health care professionals were very positive and complimentary about the registered manager, staff and how the service was operated. Arrangements were in place to monitor risks and the quality of services provided.