Comficare Limited is registered to provide personal care to people in their own homes who may have a physical disability or who may be living with dementia. The agency provides services to people in Bideford, Barnstaple, Torrington and the surrounding areas. At the time of the inspection 29 people were being supported by the service. The service employed 15 care staff.

This inspection was undertaken on 22 and 23 November 2018.

At our last inspection of the service in March 2016 we rated the service 'Good'. At this inspection we found the evidence continued to support the rating of 'Good'. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated Good.

There was a registered manager in post. 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.

Risks associated with people’s care were identified and measures were in place to reduce avoidable risks. Staff received training to ensure people were supported with managing their medicines. Processes were in place to protect people from abuse and neglect and staff were aware of how to raise any concerns.

There were enough staff to deliver the care planned and staff had been recruited safely to ensure they were suitable to work with people.

People’s liberty and choice was promoted. People were involved in decisions about their care and subsequent reviews. The registered manager and staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. This meant people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way.

The service worked in partnership with other health and social care professionals to ensure people received the care and support they required. Professionals said the service was pro-active, alert to any changes and worked well with them for the benefit of their clients.

People were supported by staff who were trained and supervised to do their job. People expressed total confidence in the staff who visited them. Comments included, “I can’t find any fault…”; “They are a very professional company” and “This company is wonderful. The care is superb…” Staff had received training relevant to their roles and were positive about the support provided.

Staff consistently demonstrated a kind and caring approach towards people. People told us, “This service had transformed our lives…” and “The standard of care is first-class…”

People’s needs were effectively assessed prior to the service commencing. Care had been planned with each person and their relative where appropriate.

There was an open and supportive culture at the service. The service sought feedback from people, relatives and staff to ensure the service continued to improve and develop. A range of checks were undertaken to help maintain the quality of the service and identify where improvements could be made.

Further information is in the detailed findings below

Comficare Limited is registered to provide personal care to people in their own homes who may have a physical disability or who may be living with dementia. The agency provides services to people in Bideford, Barnstaple, Torrington and the surrounding areas. At the time of the inspection 30 people were being supported by the service. The service employed 15 care staff.

This inspection was undertaken on 14 and 21 March 2016.

We last inspected the service on the 10 & 11 September 2014. At that inspection we found the provider was not meeting all of the regulations we inspected. The need for improvement was identified in relation to the management of medicines and records. At this recent inspection we found improvements had been made.

There was a registered manager in post. 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, who used the service, and their relatives, were complimentary about the standard of care provided. Comments included, “…I can’t praise the staff enough…some are exceptional”; “They (staff) are great friends to me…” and “The service is very good…there is never a problem…” Professionals were equally complimentary. One said, “…the service is very accommodating…” Another said, “…Comficare have found good solutions…”

People were treated with kindness, dignity and respect and they were supported to remain as independent as possible. Staff knew people well and ensured their preferred routines were met. People were involved with planning and reviewing their care. Care records were written in a sensitive and person centred way.

People and their relatives said the service was ‘reliable and flexible’; staff arrived when expected; stayed for the agreed length of time and visits were not missed. Since the last inspection two visits had been missed in error. The registered manager had apologised to the people affected.

People said the service they received was safe. Medicines were safely managed where staff assisted people, and procedures were in place to ensure people received their medicines as prescribed. Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and described potential risks and how to reduce them.

There were sufficient numbers of staff available to meet the needs of people who used the service. There was an effective recruitment and selection process in place and the necessary relevant checks had been obtained before staff were employed. Staff were suitably trained and received regular supervision and support.

Staff had an understanding of the Mental Capacity Act 2005 and when needed mental capacity assessments were completed. Staff understood the issues of consent and people confirmed staff enabled them to make choices about the care and support delivered. When people lacked capacity to make their own choices, decisions had been made on their behalf in their best interests.

A complaints procedure was in place, which people confirmed they were aware of. People’s concerns and complaints were listened to, addressed in a timely manner and resolved quickly.

People said the service was well managed. There were effective systems in place to monitor the safety and quality of the service. Regular feedback about the quality of the service people received had been sought. Where improvements had been identified there were on-going plans for improving people’s experience of the service.

The service had developed good links with other community professionals. One professional said there was good communication with the service and that they were always alerted to any concerns or problems. Another said, “We have been impressed wit