Carers Choice is a domiciliary care agency. It provides personal care to people living in their own houses and flats. The service’s aim is to provide support for carers. Carers are people or relatives who care for someone in their own home. A service was being provided for one adult with a learning and physical disability at the time of the inspection.

Not everyone using Carers Choice receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service is run by a registered manager who was present at the inspection visit to the office. 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.

This announced inspection took place on 15 August 2018.

People received safe care and treatment. Potential risks to people’s health and well-being were assessed and strategies were in place to minimise their impact on people. Staff felt confident to recognise and report any safeguarding concerns. Suitable arrangements were in place to prevent and control infection.

Recruitment practices were effective in making sure that people were supported by staff who were competent and suitable. Staffing numbers were directed by the needs of people using the service to make sure that their individual needs were accommodated.

Care was delivered in a way that promoted positive outcomes for people. Staff had the knowledge and skills they needed to provide support in line with legislation and guidance. This included specific training in how to support people to eat.

People’s health care needs were assessed and met including any assistance people required to take their medicines.

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 treated people with kindness and promoted people dignity. People had been supported by consistent staff and positive relationships had been developed. Staff knew how to communicate effectively with people. People had been helped them to express their views and to be actively involved in making decisions about their care as far as possible.

People received person-centred care that promoted their independence. Each care package was developed around the individual needs of the person and their main carers. People were given opportunities to pursue their specific hobbies and interests.

Suitable arrangements were in place to monitor the quality of the service so it could learn, improve and assure its sustainability. People's view and experiences were sought and acted on so that people felt that they were really listened to. This included processes being in place to resolve any complaints received to improve the quality of care. The registered manager was approachable and communicated regularly with people, their carers and staff.

We found that whenever possible, before people received any care they were asked for their consent and that the provider had procedures in place that would ensure they acted in accordance with legal requirements. For example we saw that where possible the person receiving the care or support had signed their care plan and service agreement.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People we talked with said “I could not do without the service they provided, staff are extremely helpful, caring and they treat us with respect. Another person said, “I feel my son is in safe hands, the staff are wonderful”. Other carers comments included “This is an excellent service”, “the priority is always the person who used the service” and “I am very happy with the support we get.” This meant that the care and support being provided was meeting peoples’ needs.

There were effective recruitment and selection processes in place. The provider kept satisfactory documentation for all staff to evidence relevant qualifications and a full employment history with satisfactory written explanation of any gaps in employment.

We looked at records and found that the provider was asking for feedback. We saw that quality monitoring questionnaires were sent to out to people who used the service annually and that the results were analysed by the provider.

There was an effective complaints system available.

People received a good quality of care and support. Care plans reflected each person’s needs and preferences. Families were involved and supported to provide care for their relatives.

We saw that peoples' needs had been assessed, with support and treatment planned and delivered in line with individual plans. We saw that assessments were used to ensure safety and welfare.

People and their families were encouraged to be involved in how their support plans were developed.

We spoke with four people and their relatives. All comments were positive. People told us they were included in the planning of their care. One person told us “the staff provide an excellent service”.

Staff we spoke with were caring and responded to people’s needs. Staff were knowledgable about people's support needs and treated people respectfully. Staff told us they felt supported by the service and received regular, quality training.

People who use the service were protected from the risk of abuse because the provider had taken all reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff were knowledgeable about keeping people safe. People told us they felt safe and confident to talk to staff if they had any concerns.

Complaints and concerns were listened to and acted upon immediately.