This inspection of Care Plus Care (UK) Limited took place on 19 December 2017 and 12 January 2018. It was an announced comprehensive rated inspection. At the last inspection in November 2015 the service met all of the regulations under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At that inspection the service was rated ‘Good’.

At this inspection we found the service continued to be rated as ‘Good’. The rating is based on an aggregation of the ratings awarded for all five key questions.

Care Plus Care (UK) Limited is a domiciliary care agency that is registered to provide ‘personal care’ to people who live in their own homes within the local authority of North Lincolnshire. It provides a service to people in Barton-on-Humber and the surrounding villages. There were 56 people receiving the service when we inspected.

The provider was required to have 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. On the day of the inspection there was a manager that was registered and had been in post for the last three and a half years.

People were protected from the risk of harm and staff were trained in and knowledgeable about safeguarding people from abuse. Risk was safely managed. Recruitment of staff followed safe practices to ensure staff were ‘suitable’ to care for and support vulnerable people. Staffing numbers were sufficient to meet people’s needs. The management of medicines was safe and systems in place demonstrated there was a safe audit trail for handling all drugs. Staff followed good hygiene for safe control of infections. These measures protected people from harm.

Systems in place acknowledged and recorded when things went wrong and lessons were learnt to ensure problems or mistakes were not repeated. Staff encouraged people to make choices and decisions wherever possible in order to exercise control over their lives. People were cared for and supported by qualified and competent staff who were themselves regularly supervised and received annual appraisals of their personal performance. Staff respected the diversity of people and met their individual needs. People’s nutrition and hydration needs were met to support their health and wellbeing.

People’s mental capacity was appropriately assessed and their rights were protected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they understood the importance of people being supported to make decisions for themselves. The registered manager followed the ‘best interests’ route where people lacked capacity to make their own decisions. Consent for support to take place was respected so that staff always sought people’s cooperation and agreement before completing any support tasks.

People were cared for with compassion by kind staff who knew about people’s needs and preferences. People were involved in their care and had their right to express views respected. The management team set good examples to the staff team with regard to attitude and approach, which meant staff had good role models to follow. Wellbeing, privacy, dignity and independence were respected. This ensured people they felt satisfied and were enabled to make choices regarding their lives.

Person-centred care plans laid the foundations for good care. They reflected people’s needs well and were regularly reviewed. People were encouraged to maintain

Information was available for staff to follow which ensured people’s needs were met. People we spoke with confirmed they were happy with the standard of care provided. Comments included, “I am more than happy with the care staff they are all really caring.”

The premises were easily accessible and well maintained. Confidential files were stored safely.

Staff were recruited safely and checks were made to ensure people were not exposed to staff who should not be working with vulnerable people.

Staff received training to meet the needs of the people who used the service. People we spoke with were complementary about the capability of the staff. Comments included, “The staff are really good they care for me really well”, “I enjoy my visits the staff are very friendly” and “All the staff are well trained, they care for (name of person withheld) very well.”

Although people told us they were involved with their care and saw the manager regularly the provider did not have formal recording systems in place which regularly assessed and audited the quality of the service provided.

As part of our inspection we asked people who used the service about their experiences of the service provided by Care plus Care. We contacted four relatives and one person who used the service via the telephone the day following our site visit.

People told us they were “very happy” with the service that was provided. Relatives told us that staff listened and involved people in making decisions about their support to ensure that individual preferences could be met. Relatives told us that staff demonstrated “care and consideration” for people that used the service and that personal choices and wishes were respected about how support was delivered.

People told us told us that staff were punctual and reliable when making their visits and that this was delivered by a consistent set of carers. One person told us that staff were "spot on" and that communication with them and the office was good. One person told us they were "over the moon” with the quality service provided, whist another said some staff were better than others, but that prompt action was taken by the office to remedy concerns once any issues were made known.

We found that records were maintained of the support that was delivered and needed. People confirmed that reviews of their support were carried out and they were aware of the complaints procedure and how to use it, if it was required.

Care Plus care UK Limited is a domiciliary care agency which is located within Barton upon Humber. The service provides personal care and support to people living in their own home.

The last full inspection of this service took place on 9 July 2014, where we found the registered provider was compliant with the regulations that we looked at. Before this inspection which took place on 20 and 23 November 2015 we contacted the registered manager to tell them we would be inspecting the service within 48 hours. This ensured that the registered manager could be present for our inspection.

The service is required to have a registered manager. 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.

Staff understood how to protect people from harm and abuse. They knew how to report abuse and told us they would report any issues to the registered manager, local authority or to the Care Quality Commission.

People’s care records reflected their current needs. Staff understood people’s needs and were aware of any potential risks to their health and wellbeing, or risks present within people’s home environment assessments were completed for all areas ofrisk.

People received person-centred care based on their preferences. People’s family were involved in the care planning process, where necessary. Staff contacted health professionals for help and advice to protect people’s wellbeing.

Staff received training which helped them to look after people safely and develop their skills. The management team were available to advise and support staff at any time. They were provided with supervision and appraisals to identify training needs and discuss their performance. Staff were provided in sufficient numbers to ensure service delivery.

We visited a person who used the service. We saw that they looked well cared for. They confirmed that the staff took good care of them and met their needs.

People were supported to take their medicines as prescribed. Staff had received training in medicine management and administration following the North Lincolnshire County Council guidance.

Staff supported people to maintain their nutritional needs and assisted them to make choices regarding their meals. This ensured people’s nutritional needs were met.

Staff understood that if people lacked capacity to make their own decisions then the principles of the Mental Capacity Act 2005 and codes of practice must be followed, which helped to protect people’s rights.

There was a quality monitoring system in place. People confirmed their views were listened too and were acted upon. There was a complaints policy in place so people could raise any issues they may have

The management team undertook audits and checks were carried out to observe how the staff delivered care to people. People’s views were sought by means of regular questionnaires. Any feedback was acted upon to make sure people remained satisfied with the service they received.