The inspection took place on the 21 March 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

Compare Care Limited is a domiciliary care service which provides personal care and support services for a range of people living in their own homes. These included older people and people living with dementia. At the time of our inspection 17 people were receiving a service.

The service is owned by a provider who is also the 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.

Staff had a firm understanding of how to keep people safe and there were appropriate arrangements in place to manage risks. One person told us “I Feel safe, they do things correctly, very nice carers”. There were enough staff employed to care for people safely and the provider had procedures in place to ensure that staff were suitable to work with people. People were supported to receive their medicines safely in line with current regulations and guidance.

Staff told us they had received training and were confident to meet people’s needs. Staff were happy with the level of support they received and told us that communication with senior staff was good. One member of staff said “We have options to do training from the local authority as well. I am booked on an end of life course next week”. Staff had a good understanding of the responsibilities with regard to the Mental Capacity Act 2005 (MCA).

People were supported to have enough to eat and drink. Care plans guided staff in offering people choices and monitoring people’s nutrition and hydration when needed. Staff supported people to have access to health care services when they needed them. One relative told us “Staff will call and contact me if there are any problems or concerns, they are good like that”. Staff told us they knew people well and recognised if they were unwell.

Staff told us they had developed positive relationships with the people they were caring for. People and relatives spoke highly of the caring nature of the staff. Their comments included, “Carers are very good, kind attentive and gentle” and “There the best, very good all of them". Staff had a firm understanding of how to protect people’s privacy and maintain their dignity. People were involved in planning their care. A relative said “The care plan is used and reviewed in the year”.

Care plans were personalised and detailed. They guided staff in how people wanted their care to be provided. Staff were responsive to changes in people’s needs. Staff were able to support people to maintain relationships and to follow interests, for example by accompanying people on outings. One member of staff told us that the person they cared for enjoyed going out in the car shopping or somewhere else of their choice.

The registered manager monitored the quality of the service by the use of regular checks and internal quality audits to drive improvements. Feedback was sought by surveys which were sent to people and their relatives. People and relatives we spoke with were aware of how to make a complaint and felt they would have no problem raising any issues. One person told us “I had one concern and spoke to the manager, and it stopped”.

Staff felt they had good communication with the registered manager and supervisor through meetings that had been held, phone calls and coming into the office. Comments from staff included “I feel supported and if I need any help, I can call up and someone is always there for me” and “Yes my manager is very good and helpful”.

We inspected Compare Care Limited on the 1 February 2016 and this was announced. The provider was given 48 hour’s notice because the location provides a domiciliary care service. We wanted to be sure that people would be in the office whom we needed to speak with.

Compare Care Limited provides personal care and support to people who wish to retain their independence and continue living in their own home. Personal care and support is provided for older people and people living with a disability. At the time of our inspection 15 people were receiving a care service.

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.

Care staff had not received full training on the requirements of the Mental Capacity Act 2005 (MCA) and identified the registered manager had failed to ensure policies and procedures relating to the MCA 2005 were in place and readily available to staff. This meant that staff would not be aware of the correct procedure to follow should there be concerns relating to someone's mental capacity. We have therefore identified this as an area of practice that needs improvement.

The registered manager monitored the quality of the service by the use of checks and internal quality audits. We found audits to be inconsistent in quality and not always recorded when they had been carried out. The absence of detailed auditing also meant the registered manager could not be assured of the quality of service delivered. We have therefore identified this as an area of practice that needs improvement.

The experiences of people were positive. People told us they felt safe and staff were kind and the care they received was good. One person told us “I feel very safe when the care staff look after me”. A relative told us “Very safe and must say trustworthy, all of the staff”

There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff at all times to meet people’s needs. When the provider employed new staff at the service they followed safe recruitment practices.

Assessments were undertaken to identify people’s support needs and care plans were developed outlining how these needs were to be met. We found that care plans enabled staff to provide the individual care people needed. People told us they were involved in the care plans and were consulted about their care to ensure wishes and preferences were met. Staff worked with other healthcare professionals to obtain specialist advice about people’s care and treatment.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and had assistance to access to health care services when needed.

People were supported at mealtimes to access food and drink of their choice and were supported to undertake activities away from their home.

There were clear lines of accountability. The service had good leadership and direction from the registered manager. Staff felt supported by management to undertake their roles. Staff were given supervision and development opportunities. For example staff were offered to undertake additional training and development courses to increase their understanding of needs of people using the service.

People and relatives said how happy they were with the management of the service. One person told us “The manager is ve

Compare Care Limited is a small, family run business that provides personal care to eight people in their own homes.

Our inspection team comprised an inspector. We considered our inspection findings to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

We spoke with three people who used the service, one relative and three care staff. All interviews were carried out by telephone after we had visited the office. Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We checked some daily records and found that care and support had been provided to people in line with the information recorded in their care plans. In one person’s daily record, we saw the time the care worker arrived, the time they left and what support they had provided. Each entry had been signed off by the member of staff who had undertaken the visit. One member of staff told us that they always looked at the daily record to see what care had been provided at the previous visit.

We saw that the provider undertook checks with the Disclosure and Barring Service (DBS) for all relevant staff. These checks had been undertaken by a company that provided DBS checks electronically, as an on-line service. This meant that the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening and that there were effective recruitment and selection processes in place.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes and to agencies providing care. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

We looked at people’s care records and saw that people were consulted in regular reviews of their care needs. People we spoke with confirmed this. One person told us that a member of staff came round to visit them, specifically to review their care plan. They said that they were asked if they were happy with their care and said, “Nothing’s too much trouble”.

One member of staff told us that they would meet with new people who came into the service. They said, “Before you start with a new client, you go through the care plan.” They also said that they were involved with regular reviews of people’s care plans which occurred every three months. This ensured that people’s current needs were reassessed and any changes needed were documented accordingly and the care plan updated.

The manager told us that all staff were given the opportunity to undertake additional qualifications, for example, the National Vocational Qualification (NVQ) in Health and Social Care. Two members of staff confirmed that they were studying towards an NVQ and one said, “It’s going really well”. Relatives we spoke with thought that staff were suitably skilled to do their jobs well. After completion of their induction programme, the manager told us, and staff confirmed, that they received additional training which was arranged throughout the year.

Is the service caring?

One person told us that they had the same two members of care staff who visited them and added, “I have the same two. They’re very, very good and they know exactly how to look after me. It’s all written down in the care plan. The staff always ask what I want first. Do you want to get dressed or washed – they always ask.”

The manager told us that they always tried to allocate the same care staff for people who used the service to ensure that they received consistent care. People we spoke with confirmed that they received visits from the same staff and that this was important to them. One person told us that they got on particularly well with one member of care staff, but that if a change was needed, they were always told in advance about this.

Is the service responsive?

One person told us that their care worker spent enough time with them and said, “Yes. Couldn’t fault them”. Another person said that they were always contacted if a visit time needed to be changed or a staff member was going to be late arriving and that “times were changed to suit all”. All the staff we spoke with felt that they had enough time to deliver the care that was needed.

We saw that there was a complaints policy in place and this outlined what action would be taken when a complaint was received and how this would be investigated and followed up. The manager told us that they had not received any complaints. They told us that questionnaires were sent out quarterly to people who used the service, their relatives and to staff. These would then highlight any complaints that people had or issues they wanted to raise. The manager added that relatives or people who used the service could make a complaint at any time.

Is the service well led?

We spoke with three people who used the service. One said, “They look after me well”. A relative we spoke with told us that they had been asked for their views on the service when someone from Compare Care Limited came to their house. They said they felt “Very positive” and that, “Staff couldn’t be more helpful or kind”. One member of staff we spoke with said, “I like it, it’s been good”. When we asked another member of staff how they felt about working for Compare Care, they told us, “Very good actually, I enjoy it”.

We inspected Compare Care Limited on 7 March 2013 and found that staff had not received appropriate training and supervision. We also found that the service did not have effective systems to regularly assess and monitor the quality of service that people received. The provider wrote to us and told us that they had taken measures to improve these areas.

We inspected the service on 6 September 2013 to check on the provider's compliance with these areas. We found that the provider had implemented training in safe administration of medicines. However, they were unable to evidence supervision and support provided to staff. In addition, the service had not taken action to implement effective systems to identify, assess and monitor the quality of the service that people received.

We spoke with one person who used the service and four relatives. People told us they were happy with the support they received and found that staff were helpful and professional.

We spoke with three people, or the relatives of people who have used the service. We also spoke with three care workers who were involved in providing care to people. All interviews were carried out by telephone after we had visited the office.

People expressed satisfaction with the agency and with the quality of care provided. People said that care workers treated them with respect and that they felt safe with the care and support they received. One person told us, "They are a very good agency." A relative told us, “We are completely satisfied with the care provided at this present time.”

People we spoke with also confirmed they had been given a copy of their care plan and that they had agreed to the care provided.

We looked at a selection of care records. We found that, prior to commencement of providing the service, people’s needs had been assessed. However, the manager was unable to demonstrate that planning and delivery of care had been routinely reviewed and reassessed to ensure they met people's current needs.

We also looked at a selection of care workers’ records. They demonstrated that all care workers had received induction training before commencing work to ensure they knew what was expected of them. However, the manager was unable to demonstrate that they had received further training and supervision in order to support them in their work.