The inspection took place on 1 and 2 November 2018 and was announced.

Cherish Care is a domiciliary care service providing support to people living in their own homes, a majority of whom are privately funded. The service specialises in providing care for people living with dementia or who are at the end of their life. The service also offers support to people with other needs, such as older people and people living with physical disabilities, to enable them to continue living in their own homes. On the day of our inspection there were 42 people receiving support from the service. The service is family run and based in Henfield, West Sussex.

The service had 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.

People and relatives praised staff as exceptionally caring and compassionate. People were supported by professional, well trained staff who they viewed as family and friends. People’s views, experience and contributions were sought and valued. The agency had a strong, visible

person-centred culture. People were at the heart of everything they did, they were made to feel valued and that they mattered. The service went that extra mile to exceed people's expectations of the service.

People received an outstanding level of person-centred care. Staff knew people's background, previous occupation, likes and dislikes extremely well and went the extra mile to create positive experiences for people.

People were matched extremely effectively with staff who shared their interests and could deliver person-centred care. There were sufficient numbers of staff to meet people’s needs. People received very good continuity of support from a care team that were flexible and adaptable in ensuring this was maintained.

People and their relatives spoke told us how highly the service was thought of in the local areas they served and how they had recommended them to others. One relative told us, “We could not ask for better support as my mother wants to be at home. I would definitely recommend Cherish carers.”

There was a very positive, inclusive culture across the management and staff team. Staff were encouraged to think creatively of ways to engage people in their interests and explore experiences to enrich their lives.

People and their relatives we spoke with told us they would be comfortable raising a complaint if needed but we found very few complaints had been raised. The provider was proactive in ensuring that complaints and issues were used to drive improvements.

Personalised risk assessments provided comprehensive guidance for staff, who were vigilant in identifying risks and took steps to reduce them. People received their medicines safely and on time from staff who were trained and assessed to manage medicines safely. Staff were trained to be aware of signs of abuse and were encouraged to report concerns, which were investigated. A robust recruitment process was in place to make sure people were cared for by suitable staff.

Staff received a comprehensive training programme to ensure they were skilled and knowledgeable to deliver effective care. Staff were receiving induction, supervisions and appraisals and told us they felt very well supported by the management team.

The service worked in partnership with professionals and outside agencies to ensure people received effective support. Staff worked with local groups like Know Dementia and Age UK to share and receive knowledge on best practices.

The provider had implemented good quality assurance systems which routinely reviewed people’s care to drive improvement. The service was following best practice guidance from the National Institute of Health and Care Excellence, in

The inspection took place on 1 March 2016 and was announced.

Cherish Care is a domiciliary care service providing support to 35 people living in their own homes, a majority of whom are privately funded. The service specialises in providing care for people living with dementia or who are at the end of their life. The service also offers support to people with other needs, such as older people and people living with physical disabilities, to enable them to continue living in their own homes. On the day of our inspection there were thirty-five people receiving support from the service. The service is family run and based in Henfield, West Sussex.

The service had 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.

People told us they felt safe. One person told us “I feel absolutely safe.” Staff had received induction training and had access to ongoing training to ensure their knowledge was current and that they had the relevant skills to meet people’s needs. People were safeguarded from harm. Staff had received training in safeguarding adults at risk, they were aware of the policies and procedures in place in relation to safeguarding and knew how to raise concerns.

Staff had undertaken essential training as well as training that was specific to people’s needs and conditions. People felt that the staff were well trained and felt confident that they had the right skills to meet their needs.

Risk assessments had been undertaken and were regularly reviewed. They considered people’s physical and cognitive needs as well as hazards in the environment and provided guidance to staff in relation to the equipment that they needed to use and the amount of staff required when assisting people. People were encouraged and enabled to take positive risks. People’s independence was not restricted through risk assessments, instead risks were assessed and managed to enable people to be independent. There were low incidences of accidents and incidents, those that had occurred had been recorded and were used to inform practice.

People received their medicines on time, these were administered by staff that had undertaken relevant training and who had their competence regularly assessed. People were asked to give their consent before being supported with these and there were safe systems in place for the storage, administration and disposal of medicines.

People told us they were asked for their consent before being supported. For example, when being supported with their personal hygiene or to take medicine. Mental capacity assessments had been undertaken to ensure that for people who lacked capacity appropriate measures had been taken to ensure best interest decisions were made on their behalf.

People had access to relevant health professionals to maintain good health. People were supported with their hydration and nutrition and were offered support according to their needs and preferences.

The provider had reviewed their systems and improved these to ensure that people were integral to the care they received. People were involved in their care and decisions that related to this. There was a strong emphasis on who the person was, what made them unique and what skills and abilities they had. People were asked their preferences when they first joined the service and these were respected and accommodated. Regular reviews and meetings provided an opportunity for people to share their concerns and make comments about the care they received.

The provider had devised innovative systems to ensure that people received support from staff that had similar interests to them, encouraging positive relationships to develop. For example, they had de

We spoke to four people who used the service, two relatives of people who used the service, the Directors – one of whom was the registered manager and four staff members including the office co-ordinator, the training manager and two personal carers.

.

People told us that they received the care and support they required to meet their needs. They said that their care and support needs had been discussed with them and the care they received reflected this. One person said, "I'm very happy with the agency and with the care I receive. I would recommend it to anyone." Another person commented, "The carers are all very helpful, very punctual and very polite."

We looked at systems in place for the handling of medicines. We found that staff were trained and appropriate records were maintained.

We reviewed the recruitment practice followed and systems in place to monitor the quality of the service provided. We found the recruitment practice was thorough and well documented. Systems to monitor the quality of the service had been established and included the views of people who used the service.

The service had effective systems in place to deal with people's comments and complaints.

During our inspection we found that systems for consultation and communication were effective and people were treated with respect and dignity. As far as practicable, they were involved in making decisions about their individual support.

We found that people receiving support from Cherish Care benefitted from a dedicated management structure and care workers who were clearly committed to providing consistent and good quality care.

We found that comprehensive and well maintained care plans enabled care workers to meet people's assessed support needs in a structured and consistent manner.

We found that people receiving a service were protected, through robust policies and procedures and effective staff training relating to safeguarding vulnerable adults.

Positive comments received from people receiving a service, or their relatives, indicated satisfaction with the care workers and the support services provided:

“I’m totally satisfied and have no complaints at all. The carers are brilliant and I have all the help and support that I need. Every other month the manager or someone from the office will call round to ask how I am and see if there is anything that could be done better”.

“I think they are absolutely amazing. It’s been a very traumatic year for us and everyone at Cherish Care has just been so kind. They couldn’t have done more for us and I know I couldn’t have managed without them. I just can’t speak highly enough of them”.

We were told that, in accordance with their identified wishes and individual support plans, people are encouraged and enabled, as far as practicable, to make choices about their daily lives.

Positive comments from people who receive a service from Cherish Care indicated a high level of satisfaction with the agency and the care and support provided:

‘I couldn’t ask for more. The carers all know what I need, they listen and they are really like a family to me’.

‘I can’t praise them enough. They will do anything – absolutely anything. All I have to do is ask’.

‘I have used other agencies in the past, but Cherish Care are the tops!’