Carers Trust North Bucks and Milton Keynes provides people with personal care and support in their own homes. They have a rural office in Buckinghamshire and provide people with care packages around north Buckinghamshire and Milton Keynes. When we inspected they were providing 39 people with personal care support packages.

At our previous inspection on 30 March 2016 we found that the service was in breach of one legal regulation. The service had not taken steps to assess risks to the health and safety of people, or taken sufficient action to ensure that risks would be mitigated against. This was a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We asked the provider to send us an action plan to tell us what action they would take to meet this breach. We reviewed their action plan and carried out this visit to ensure they had carried out the improvements within that plan, as well as improvements in other areas of the service. Following the inspection we found that the service was no longer in breach of our regulations.

We found that there had been improvements to the way that risks were managed at the service. Risk assessments were in place and were more comprehensive in identifying areas of risk. Future work was also planned to improve the way these documents provided staff with information about actions they should take to help mitigate risks.

People felt safe in the care they received from the service and staff had a good knowledge of abuse and potential indicators that abuse had taken place. There were systems in place to record and report any incidents, including concerns around abuse, which took place and appropriate contact was made with external organisations. Staffing levels were sufficient to meet people's specific needs and people were usually able to see regular and familiar staff. Staff had been recruited following robust procedures to ensure they were appropriate and of good character to be working with people.

If necessary, staff were able to support people to take their medication but where possible, people did so independently. There were systems in place to ensure medicines were recorded when staff did support people with them and these were reviewed to ensure this was done so properly.

Staff members received training and support from the provider to ensure they were able to perform their roles. New staff received induction training and there were regular updates and ongoing training for established staff. Supervisions took place to provide staff with opportunities to discuss their roles, any concerns they had and future training needs.

People's consent to their care, treatment and support was sought by staff on a daily basis. People signed their care plans to show they agreed to them and were empowered to make decisions for themselves. None of the people the service cared for were assessed as lacking capacity to any decisions, however, the service did have systems in place to ensure they were meeting the principles of the Mental Capacity Act 2005 should the need arise. People were able to choose what they wanted to have to eat or drink and staff only provided the assistance that people required, so as to maintain people's independent living skills. If necessary, staff were also able to support people to access appointments with healthcare professionals, such as their GP, and took action to ensure their recommendations were followed in people's care plans.

Staff treated people with kindness and compassion. They took the time to get to know the people they were caring for and were motivated to perform their roles and make sure people got the care they needed. People had been involved in the writing of their care plans and were provided with information and updates about the service. Staff members took action to ensure that people were treated with dignity and respect at all times and that their privacy was maintained.

Care plans were based o

This inspection took place on 30 March 2016 and was announced.

Carers Trust North Bucks and Milton Keynes provides personal care to people living in their own homes. When we inspected they were supporting approximately 37 care packages.

The service had a registered manager. 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 current registered manager had been in post on a temporary basis and was due to leave the service shortly after our visit. A new manager had been appointed from within the service and was aware of the requirement to register with the CQC.

Risks to people had been identified by the service; however risk assessments were not comprehensive and did not provide members of staff with guidance and control measures to minimise the impact of those risks. People were cared for by staff that were aware of abuse and potential signs of it. They knew and understood safeguarding procedures and were prepared to report any concerns they had. There were sufficient staffing levels to ensure people received the care they required. Staff had been robustly recruited by the service to ensure they were of good character to work with people. Where necessary, people were supported to take their medication by trained members of staff.

Members of staff sought people's consent however the service did not have systems in place to ensure they complied with the Mental Capacity Act (2005). They did not demonstrate how they supported people who were unable to provide capacity or make their own decisions. Staff members received sufficient training and support to perform their roles and to develop their skills. If required, staff supported people to have sufficient food and drink, as well as to book and attend appointments with healthcare professionals.

People had strong and positive relationships with members of staff. Staff treated people with kindness and compassion and spent time developing a professional relationship with them. People and their family members were involved in planning their own care and were provided with information about the service. Staff ensured that people were treated with dignity and respect at all times.

Care plans were written following initial assessments of people's needs, to ensure they received person-centred care. These care plans were reviewed on a regular basis with the input of people and their family members to ensure they were an accurate reflection of their needs and wishes. The service had a clear complaints procedure in place and people were prepared to raise any concerns about their care. There were systems in place to log concerns and ensure that appropriate action was taken as a result.

The service did not have regular and robust quality assurance procedures in place to monitor the quality of care and drive improvements. This had been identified by the provider and work was in progress in this area. There was an open and positive ethos at the service. People and staff were positive about the management and the provider and felt that they were well supported.

With their prior agreement we met and spoke with five people in their own home and we also spoke with another five people on the telephone. We asked them to tell us about their experience of receiving a service and they all confirmed they were pleased with the quality of the care and support provided by their care workers.

Comments made about the care workers included, “Always cheerful and conscientious…”, and “We rely on them and they have never let us down.”

We found that the domiciliary support people received was provided by competent and experienced care workers. We saw that the agency office was efficiently organised so that people consistently received a safe and reliable service when they needed it.

We found the agency office was well organised, appropriately staffed and equipped, and we heard staff dealing with telephone enquiries in a helpful, friendly manner. We spoke with eight people who used the agency's services. Each person confirmed that they had received a reliable service from care workers who knew their job and treated them with respect. One person commented, "They are brilliant. They are all very kind and helpful." Another person said, "They keep good time and they are all so pleasant. I have every confidence in them."