Care Options provides personal care services to people in their own homes. At the time of our inspection 66 people were receiving a personal care service from the agency, most of whom were older people or people with physical needs.

The inspection took place between on 12 September and 5 October 2016 with visits to the Care Options office on both of these dates.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run. The registered manager was also the provider of Care Options.

We previously carried out an inspection of this service on 19 December 2013 where we had no concerns. We made one recommendation as a result of this inspection. Whilst the service had received no formal complaints, it was clear that minor issues had been raised and dealt with by the management team. These issues were not always documented. As such we asked the provider to consider ways of capturing people’s concerns in order to identify and possible trends and themes.

There were systems in place to ensure the service safely recruited sufficient and appropriate staff to support people. Once employed, staff completed a comprehensive programme of induction and training to ensure they had the necessary skills and experience to meet people’s needs. Communication systems across the service were good and staff were supported and enabled by the management team to deliver safe and effective care.

People’s needs and homes were fully assessed before care was provided. As such, any risks associated with their care were identified and managed safely. The service had appropriate systems to safeguard people from the risk of harm or abuse and staff were knowledgeable about how to keep protect people and keep them safe.

Care staff worked in small geographical teams which meant that most people benefitted from the support of a regular team of staff. People told us that care staff knew them well and that as a result they received consistently good care. Staff were kind and compassionate and demonstrated the values of the agency to provide high quality care. People received care that was provided in a respectful way that promoted their privacy and dignity.

The service was responsive to changes in people’s needs and tailored their services accordingly. People were involved in the planning and reviewing of their care and supported to be as independent as possible. Staff respected people and their decisions. Staff understood the importance of gaining consent from people and demonstrated an awareness of the Mental Capacity Act 2005. Staff were clear about what they should do if a person refused to accept their care.

People were supported to maintain good health. The service worked in partnership with other healthcare professionals to ensure people had access to the necessary services and support they needed. Where people were supported with their medicines, this was done safely. Staff received training in the management of medicines and checks were carried out to ensure they were competent in this area. People told us that staff supported them with their medicines appropriately.

Staff understood the importance of supporting people to maintain adequate nutrition and hydration. Care plans identified people’s risks and staff were knowledgeable and creative in the way they supported people to eat and drink safely.

Care Options had good systems in place to monitor and improve the quality of its services. People were regularly asked for their feedback and satisfaction surveys sent to both people and staff were used to identify areas of concern or improvement.

We visited and spoke with two people who use the service and a person's relative in their homes. We spoke to seven people by phone, three of whom were people's relatives. People we spoke with told us that they were asked for their consent to the care they received and that the provider acted in accordance with their agreed care plan.

We reviewed the care plans of nine people and we found that people's individual needs were assessed and that care was planned and delivered to meet their needs and promote their welfare. A person said "they (staff) listen to me and what I want - I am 100% satisfied". A person's relative said "if I need help I can call them they are brilliant with dad, their attitude is helpful and friendly and the care plan is accurate".

We found that the provider had appropriate arrangements in place to manage people's medicines.

People told us that they were satisfied with the standard of care they received from the provider's staff. We found that the provider carried out the relevant checks to ensure people were supported by staff that were trained, experienced and of good character. A person's relative said "they know their needs very well and are very good".

We found that people were asked about the quality of service they received and that the provider had suitable arrangements in place to identify and manage risks to people who used and worked in the service. A person said "my relationship with the provider is excellent".

We visited Care Options, a service providing care to people in their own homes. They mainly supported adults with disabilities and older people with dementia. We spent time reading documentation including personalised care plans and daily records for people with various needs. These demonstrated the individual care and support given to each person.

We found that care plans were reviewed on a regular basis and information was clearly documented. Staff explained that they had to write a monthly report for each person, . If there were significant changes then the review of their care was brought forward and a new assessment was undertaken.

We found that people spoke positively about the agency, with comments such as "I am very happy with the carers that visit, and they are all friendly and accommodating." "We have always found the carers very good and helpful," and "All the staff that I have met have provided a good service and they have been very supportive."

There were policies and processes in place for ensuring that staff were trained, supervised and had yearly appraisals. The agency had systems in place to monitor the quality of the service and kept the Care Quality Commission informed of any incidents.

We spoke to one person who used the service and four representatives of people who use the service.

They all said that they were happy with the service provided and that, in general, the care given was good. All the people we spoke to described the staff as very good and one told us that the care staff who visit them were “excellent”. However one representative told us that the care staff that work at the weekend were not very good and they had stopped receiving care at the weekends because of this.

We were told that the care staff were always polite, friendly and sometimes did “above and beyond” what they should.

Some of the people we spoke to said there was sometimes a problem with the times that visits were carried out and that they were not always told when the care staff were running late.