Cumbria View Care Services Limited (Cumbria View) provides to adults in their own homes in South Cumbria and North Lancashire. The agency also provides a night care service, palliative care and domestic support to assist people to stay independent within their own homes.

People’s experience of using this service:

•The service met the characteristics for a rating of "good" in all key questions.

•People told us they felt they received care in a safe way. We were told staff were “very good” and “skilled”, “well trained” and “I feel totally safe'.

•Sufficient numbers of suitably trained and skilled staff were being deployed to meet people’s individual needs.

•Staff had received a range of training and support to enable them to carry out their work and support people safely. Staff received induction training, supervision and support so they could support people effectively.

•The service had a thorough recruitment process to help ensure new staff were suitable to work with the people in their homes.

•The provider had safeguarding systems. Staff were aware of the procedures for this and had received training on it.

•Only staff who had received training in safe medicine administration were able to give medicines.

•Staff were supplied with personal protective equipment for use to prevent the spread of infections. Staff had received training in infection control.

•There were effective systems for assessing and managing risk to help make sure all were kept safe from foreseeable risks.

•The registered provider had procedures for assessing a person's mental capacity in line with the Mental Capacity Act 2005.

•People and relatives told us the service was caring, well-led and staff knew them well and respected their needs and preferences.

•People and their relatives were aware of how to raise concerns or complaints. Complaints received had been investigated and responded to in line with the provider's procedure.

•Checks and audits were carried out to determine the quality of the care and people who used the service were asked for their views on service provision.

•People and their relatives were happy with how the service was managed. Care staff told us the management team set high standards.

Rating at last inspection: Good. (The report was published on 2 September 2016).

Why we inspected: This inspection was part of our routine scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:We will continue to monitor intelligence we receive about the service and plan to inspect in line with our inspection schedule for those services rated Good. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We carried out this announced inspection from 13 June to 22 July 2016. We last inspected this service on 17 June 2014. At that inspection we found that the provider was meeting all of the regulations that we assessed.

Cumbria View Care Services Limited provides personal care to adults in their own homes in South Cumbria and North Lancashire. The agency also provides a night care service, palliative care and domestic support to assist people to stay independent within their own homes.

There was a new manager employed at the service. The manager had applied to us to be registered. The previous registered manager had left the service on 23 March 2016. 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 received the care they needed from care staff who they knew and who knew them well. The staff were friendly, kind and caring and people valued the service they received.

The care staff were trained and supported to be able to provide the care people needed.

People were protected against the risk of abuse or avoidable harm. Hazards to people’s safety had been identified and managed. The care staff took prompt and appropriate action if they were concerned that a person was at risk.

People were included in planning and agreeing to the care they received. People could ask for changes to their planned care and the service agreed to these where possible.

Medicines were handled safely and people received support with their medicines as they needed.

People received the support they needed to prepare meals and drinks.

The manager was very knowledgeable about the Mental Capacity Act 2005 and her responsibility to protect the rights of people who could not make or express their own decisions.

The registered provider set high standards and monitored the quality of the service to check these were maintained.

The manager of the service was supported by local care coordinators. People knew how they could contact a member of the management team if they needed to. There were arrangements in place to ensure the effective management of the service.

We have made a recommendation about the use of equipment in people’s homes.

Below is a summary of what we found. We contacted, after obtaining their permission, people who used this agency. We did this to ask them about their experiences of using the service and the support and care the agency had provided. We also spoke with the managers and care staff who worked for the agency. The summary is based on our observations during the inspection, speaking with the staff, people who used the service, relatives and from looking at records.

During this inspection we also checked if compliance actions from the last inspection we carried out in November 2013 had been completed. Some of these matters we needed to check did not necessarily relate to people's views and experiences. Therefore at this visit we did not ask people to comment on all of the outcomes we looked at.

During the inspection we gathered evidence against the outcomes we inspected to help answer our five key questions; is the service safe, effective, caring, responsive and well led?

Is the service safe?

We reviewed the recruitment records of four staff recruited since our last visit and the records of people currently in the process of being recruited. We saw that all staff had been recruited using an effective and robust procedure that included all of the appropriate checks to ensure that the person being employed was suitable. We saw that the company’s written policies and procedures in relation to the safe and effective recruitment of suitable staff had been revised since our last visit.

Is the service effective?

The summary of the questionnaires we looked at showed that one third of all those asked whether they were satisfied with the service said they were extremely satisfied. Nearly two thirds of those asked said they were very satisfied.

Is the service caring?

The relatives and people we spoke with told us they were “extremely happy” with the service provided and said the support provided was “excellent’’. One person who used the service we spoke with said, “The staff are really nice’’. They also told us that staff had been appropriately trained to meet their needs. All of the comments made by people we spoke with were very positive about the staff and care they received.

Is the service well-led?

The manager took the lead in coordinating care between the different agencies and services involved in people's care. We found clear records of information sharing with other agencies who were involved in a person’s care. This promoted effective communication in delivering the care and support plans.

Is the service responsive?

There was a clear record of how complaints had been managed and resolved. People that we spoke to told us that if they had any concerns they would be more than happy to speak to the staff or manager about it. One person we spoke to said ‘’If there was a problem I’m confident it would be sorted’’.

We spoke with nine people who used the service and seven relatives of people receiving care from Cumbria View Care Services. People we spoke with told us they had been involved at the assessment of their needs and part of the decision making about how their needs would be met by the service.

The relatives and people we spoke with told us they were ‘’extremely happy" and ‘’thoroughly satisfied’’ with the support provided and said the service provided was ‘’excellent’’. One person we spoke with told us, ''It’s marvellous care and the girls deserve a medal’’.

The recruitment procedures stated that staff would receive three observational supervisions during their induction period. We did not see that this was consistent for all staff that had been employed since our last visit.

We looked at a number of Client Quality Questionnaires completed by the agency at different times over the last year. We did not see how this information was collated to inform the service overall. We were told that when clients raised matters these were dealt with on an individual basis. Comments we saw made by clients were generally very positive. One person wrote, ‘the girls are lovely, never late and I’m confident with what they do’ however, another wrote, ‘they [the staff] appear to rush’

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld, and how they can make choices about their care.

We carried out 11 telephone interviews to people who use the service and to their main carers (a relative or friend) to gain views about the service. We visited the office on the 17 October 2012 to look at records and talk to the person in charge. We also talked to senior staff and two care workers. We contacted the local authorities who have a contract with the agency, and the social workers who assess and place people with the agency. We also contacted healthcare professionals who have an input into the care people received from the service.

The people we spoke with who received care from the agency told us Cumbria View provided good quality care and offered a reliable service. Typical comments we received were, “I cannot fault them, the carers (care workers) are all very good, polite and kind" and another said, "I look forward to the visits, they have become like friends now." A number of people told us they liked the fact they got regular care workers, one person said, "It's very rare I get someone (care worker) I don’t know, and that’s only in emergencies, and the office let me know what’s happening."

The majority of people we spoke with reported that the care workers turned up on time and always stayed the set amount of time. A typical comment was, "The timings are near enough, we live in a very busy town so you've got to give then some leeway, but they usually ring ahead if they are going to be late."

People told us they had been asked by the agency about the care they needed and said the care staff treated them, their families and homes with respect. People told us, "The manager came to work out with us what we needed, and every now and again she will pop out or ring up to see we are still happy."

Healthcare professionals told us that the agency was good at offering more specialised care and working as part of a team with them. This was particularly the case when supporting people at the end stages of life and who were being cared for at home.

We contacted people who receive care from the agency and spoke to family members of other people who are supported by the service. We asked people for their views about the service and the care and support staff provide.

The people we spoke to told us they were very happy with the support provided and said the service provided a good quality of care. People said they had been included in agreeing the care to be provided by the service and had a copy of their care records. Everyone we spoke to told us they felt safe receiving care from the service. They said they knew who they could speak to if they had a concern or complaint and said they would be confident raising concerns with the manager of the agency.

People said,

"The staff are very good. They are well trained and able to provide the care I need".

“I tell the staff what care I want”.

“They are absolutely marvellous, just so professional, I give them 10/10".

"I'm very happy with the service but would tell them if I wasn't".