Choice Care’s services are aimed at helping the elderly, disabled, people living with learning difficulties, terminally ill, families and those convalescing. The office is situated close to the town centre of Blackburn with good rail and bus routes. There is a well equipped office with access for the disabled and a car park. The service is available on a 24 hour call out system for emergency assistance. There are facilities for staff to be trained and supervised. On the day of our inspection there were 210 people using the service.

At the last inspection this service was rated Good. This was an announced inspection which took place on the 23 and 24 May 2017. We gave the service 24 hours notice of our inspection to make sure people were in the office and arrangements could be made to visit people in their own homes with their consent. At this inspection we found the service remained Good.

People who used the service told us they felt safe when staff members were in their homes. Staff had received training in safeguarding and knew their responsibilities to report any concerns. The service also had a whistleblowing policy in place.

Risk assessments were in place to keep people safe, including moving and handling, medicines and nutrition. These were reviewed regularly to ensure they remained relevant. Staff were also trained in the use of equipment such as hoists, slings and stand aids.

Recruitment systems and processes in place were robust. We saw references, identity checks and Disclosure and Barring Service checks were completed before staff were employed.

People who used the service and staff members told us staffing levels were adequate. The registered manager told us that recruitment was an on-going process to ensure staffing levels remained adequate.

Only staff members trained to do so were able to support people with their medicines. We saw staff members competencies were checked every three months or more if required. This should ensure people who used the service received their medicines safely.

All new staff members were expected to complete an induction when they commenced employment. Those new to care work were required to undertake the Care Certificate. The Care Certificate is considered best practice for those new to the care industry.

Staff members told us and records confirmed that they received supervisions and appraisals on a regular basis. All staff members told us they were able to discuss any training requirements they had.

We observed some carers undertaking tasks in people’s homes. We observed they were kind, caring and respectful in their interactions with people and respected people’s privacy and dignity when undertaking personal care tasks. All the people we spoke with told us staff were kind and caring.

We have made a recommendation about the management of complaints.

Care plans in place for people contained detailed information to direct staff on how to meet people’s needs. All the staff we spoke with felt they knew people they were caring for well.

All the staff members we spoke with told us the registered manager was approachable and they felt well supported in their roles.

One staff member had received The Home Care Worker of the Year Award 2017 in recognition of their dedication to improving the quality of life for service users.

Policies and procedures had not been reviewed since they were put in place in July 2014. We discussed this with the registered manager who took steps to action this during our inspection. They informed us that updated policies and procedures would be put in place as soon as possible.

The service had received numerous compliments, thank you cards and letters from people who used the service and their relatives.

The service is registered to provide personal care for people who are elderly, are recovering from illness, have dementia, are physically disabled or are terminally ill. The service is provided in people’s homes.

We last inspected this service in September 2013 when the service met all the standards we inspected. This unannounced inspection took place on the 24 March 2015.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were aware of and had been trained in safeguarding procedures to help protect the health and welfare of people who used the service. All the people who used the service said they felt safe. Staff were recruited using current guidelines to help minimise the risk of abuse to people who used the service.

People who used the service had mental capacity. Some staff had been trained in the Mental Capacity Act (2005) and should be aware of when a person needed to have a deprivation of liberty safeguard hearing to protect their rights.

Staff had access to a wide range of training and supervised on a regular basis, including spot checks, to ensure they were performing well. People were assisted by trained staff if they required their medicines to be administered for them.

There was a modern office with all the necessary equipment to provide a functional service for people who used the service and staff. The equipment was suitably maintained and fire precautions were undertaken such as emergency evacuations.

People who used the service helped to develop their plans of care to ensure their wishes were taken into account. Plans of care were updated regularly. The plans contained details of people’s preferences and interests to help them retain their individuality.

Risk assessments were conducted to help keep people who used the service and staff safe. This included a comprehensive assessment of people’s homes to detect any hazards to safe care.

The registered manager updated policies and procedures and conducted audits to help ensure the service maintained standards.

The registered manager conducted audits to check on how well the service was performing.

The complaints procedure gave people sufficient information of how the service would respond and how to take a concern further if they wished.

The manager is registered with the Care Quality Commission and we saw evidence of their registration certificate on display in the office.

We spoke with seven people who used the service. They told us staff asked permission before carrying out any activity. Comments received were, “The staff always ask permission and give me choices” and, “The staff are very pleasant and they ask permission”. Another said, “The carers are good, they ask permission, they knock on the door and they are respectful”.

We asked staff to tell us how they ensured people who used the service received safe and effective care. Comments received were; ‘I am aware of the importance of care planning and being person centred. All staff read the care files’. ‘Everything about peoples care is in the care file”.

Staff confirmed they had regular supervision and we saw evidence of this in the staff files we looked at. We saw completed appraisals forms and staff told us they had been completed but not all in the last year.

We spoke with seven people who used the service. Most were able to tell us who to go to if they had any concerns. One person said, I have no complaints but I would call the office”. Another told us, “I have no complaints I would speak to the manager if I had concerns”. One person told us “. One person told us they had no complaints but was not aware who to contact if they had concerns”.

We spoke with ten people who used the service and three relatives. Everyone we spoke with told us they were satisfied with the care and support received. We saw records that showed people who used the service and their relatives were involved in developing their own plans of care. People we spoke with said they understood their care and support plans and that staff had explained things to them in detail.

People told us that staff were knowledgeable regarding their support needs. They said they were treated well.

One relative told us that on the whole they received the same care worker, however there had been an unsettled period about three months ago. They thought this had been because there had been staff changes, but the relative told us the agency had tried to minimise the impact this had had. Another relative told us that if they had a complaint they would contact the manager and they were confident it would be dealt with properly.

We looked at people’s care records. We found records were accurate, up to date and regularly reviewed. We also saw how the organisation included people in decision making throughout their treatment and support. We looked at staff records and found staff were well trained and saw there were good systems in place to ensure they were well supported in their work.