Coniston Care Scheme was founded in 1995. It evolved through a community partnership including local people, the GP and community nurses, in response to the needs of the local community. It provides personal care and domiciliary services to people living in their own home in the village of Coniston and surrounding rural areas.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service mainly to older adults. Not everyone using Coniston Care Scheme receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At our last inspection we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated any 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. At this inspection we found the service remained 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.

There were sufficient numbers of suitable staff to meet people’s needs. Staff training was on going and they had received sufficient training to safely support and care for people. Staff were supported by the registered and deputy manager through regular staff meetings, supervision and appraisals.

When employing fit and proper persons the recruitment procedures had included all of the required checks of suitability.

Hazards to people’s safety had been identified and appropriately managed.

People’s dignity and privacy were actively promoted by the staff supporting them.

People received care from a small team of staff who they knew well and were treated with respect. Everyone we spoke with made very positive comments about the staff who supported them or their relatives.

Auditing and quality monitoring systems were in place that allowed the service to demonstrate effectively the safety and quality of the provision.

The focus of the service was on promoting people’s rights. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us this was an excellent service and said they would recommend it.

People received the support they needed to take their medicines safely. The staff identified if people were unwell and supported them to contact health professionals.

People were asked for their consent before care was provided and the decisions they made were respected.

Further information is in the detailed findings below

This announced comprehensive inspection took place on 28 October 2015. The provider was given 48 hours’ notice of the visit because the location provides support and personal care to people living in their own homes.

Coniston Care Scheme was founded in 1995. It evolved through a community partnership including local people, the GP and District Nurses, in response to the needs of the local community. It provides a wide range of domiciliary services to the people of Coniston and surrounding rural areas.

During our previous inspection visit in March 2014 we found the service had met all of the essential standards we looked at. Since then there had been no incidents or concerns raised that needed investigation.

There was a registered manager in post on the day of our inspection visit. 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. In this service the registered manager is also the registered provider.

We found that not all the information relating to the administration of medications had been recorded accurately in some people’s care records. Staff who were responsible for the administration of medications had completed the appropriate training.

We found that people who used this service were safe. The staff knew how to protect people from harm. Staff had completed training in the safety of vulnerable adults and knew the signs to look for and how to report any incidents of concern. There were good systems in place to ensure people knew the staff that supported them.

We saw that recruitment procedures were robust this ensured only suitable people worked in the service. We saw that staffing levels were good with a number of flexible part time staff supporting the registered manager and care manager. Staff training was up to date. We saw that staff team were supported by the management team through regular staff supervision, appraisals and team meetings.

We found that the service worked very well with a variety of external agencies such as social services, other care providers, local GP’s and community nurses to provide appropriate care to meet people’s physical and emotional needs.

Observations made during our inspection showed people were given choices about how they wanted to be supported and how they wanted to live their lives. Support was given in a manner to people to promote their independence for example supporting them to join in with activities in the local community.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice. This helped to protect the rights of people who were not able to make important decisions themselves. Best interest meetings were held to assist people who were not always able to make difficult decisions for themselves and where relevant independent advocacy could be arranged.

People received support from a regular team of staff who they knew well and who understood the care and support they required. We saw that people were treated with kindness and respect and they made very positive comments about the staff who visited their homes.

We recommended that the provider ensured the records relating to the administration of peoples medications were accurate. Reflected their current needs and that they followed the guidance from The British Pharmaceutical Society as described in The Safe Handling Of Medicines in Social Care.

Following the last inspection in October 2013 we set a compliance action for the provider to ensure they operated a robust and effective recruitment procedure to protect the interests of the people using the service. Also to ensure that people employed were of good character, mentally and physically fit for the work to be carried out.

The actions taken by the provider included a review of their recruitment and selection policy and procedures. We saw that these reviewed procedures were clear about the necessary checks that would be completed.

We were told by people using the service the carer always asked for consent when performing tasks. They said, ‘’She (the carer) knows me well and how I like things to be done’’.

People we spoke with using the service told us they were ’’very happy" and ‘’thoroughly satisfied’’ with the support provided and said the service provided was ‘’excellent’’.

For most people employed there were no records of checks made about previous employment and whether previous employers had any concerns. If there were any concerns about their character they could not be checked by the agency prior to employment.

The people we spoke with told us that they were, “Very happy with the service and had no concerns.” They also told us that they knew who to contact if they did have concerns or comments to make about the service they received from Coniston Care Scheme.

We saw policies and procedures were in place for managing complaints. People were given information in the service user's guide about what to do if they needed to make a complaint.

We did not speak with people using the service as part of this follow up inspection. We found that people who used the service were protected from the risk of abuse by staff who were supported to deliver care and treatment safely and to an appropriate standard. People were protected from the risks of unsafe or inappropriate care because accurate and appropriate records were maintained and there was an effective system to monitor the quality of service that people received. The provider had made the necessary improvements to the service in order for it to be compliant with the Health and Social Care Act 2008.

The people we spoke with during our inspection of this service told us that:

"The service I receive is marvellous, I couldn't manage without them."

"I have a copy of my care plan and the staff do everything I require every day. They always ask me what I want or need. They look after me really well and do extra things for me too."

"In my opinion the staff are very competent, I have every confidence in them."

"They (the care workers) are very careful. Two staff always attend as I need to use a hoist."

"I absolutely trust them (the care workers) fully, they know what they are doing."

"It is the best service."

"Things always run smoothly. I know other people who have service from different care agencies and they don't get a good service like this."

We spoke with people who did not use the service directly but who did have contact with the agency.

They told us that they did not have "any concerns about the care people receive" and added " we would much rather people be looked after by Coniston Care Scheme than any other, bigger agency."

Another person said; 'I must praise them for the care they are giving to one of my own clients at present. This is a complex case and they have liaised throughout with the districts nurses and been guided by them."

One of the stakeholders we spoke to said " the staff were extremely competent. I have no concerns about what they do or the care people get."

They also told us; "I always get good feedback and have never heard of any complaints about this service."