We carried out this inspection on 9 and 10 April 2018 and it was announced 48 hours in advance in accordance with the Care Quality Commission's current procedures for inspecting domiciliary care services. The service was last inspected in December 2015 when it was found to be meeting the regulations and was rated as ‘Good’ overall.

Duchy Care provides personal care to people who live in their own homes in the Newquay and surrounding areas of Cornwall. At the time of our inspection the team of 22 care staff were providing support to approximately 43 predominantly older people.

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.

Everyone told us staff were kind, caring and compassionate while also being respectful of people’s privacy and dignity. Comments included, “People that work for Duchy are worth their weight in gold”; “I can’t speak too highly of them”; “Nothing is too much trouble for them”; “They are respectful of my dignity; I don’t see how they could be more respectful” and “I think they are marvellous.”

People were supported by a stable staff team who knew people well and had received training specific to their needs. People told us they were introduced to new staff before they supported them in their home and although they had experienced changes in the staff team over time people were positive about the quality of service they received. People said they had built up positive relationships with staff. Comments included, “I get a variety of carers; I’m fine with that”; “I get different carers, they are all very respectful” and “My carers were changing but they are going to give me a regular carer.”

The staff team comprised of male and female carers of differing ages, from 23 years to retirement age. People told us they could request a male or female carer according to their preference and wherever possible, this would be accommodated. People’s preferences in relation to the gender and age of their care workers were respected during the visit planning process.

The service's visit schedules were well organised and at the time of our inspection visit there were a sufficient number of staff available to provide people's care visits in accordance with their preferences. This meant people received home visits at their preferred time. People told us staff were never rushed and were kind and respectful in their approach. People also confirmed they had not experienced any missed calls, received their visits as scheduled and were informed if there were any significant delays that would impact on them. We reviewed service rotas which demonstrated that visits were generally provided as scheduled. Staff were provided with appropriate travel time and consistently provided the care visits of the correct visit length.

Care records were up to date, had been regularly reviewed and accurately reflected the person's care and support needs. They provided clear direction for staff about the appropriate support required. Risk assessments clearly identified any issues and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence.

People said staff were well trained and understood how to meet their specific care needs. Training records showed staff had been provided with the necessary training to do their job, which had been refreshed regularly. Staff told us they were provided with appropriate training to meet people’s needs. We spoke with an external training consultant who had experience of how the service trained staff. Their comments included, “I have been involved as a training advisor with Duchy Care for

Duchy Care provides personal care to people who live in their own homes in the Newquay and surrounding areas of Cornwall. At the time of our inspection the team of 22 care staff were providing support to approximately 44 predominantly older people.

Everyone told us they felt safe and were well cared for by Duchy Care. People’s comments included; “I feel safe”, “The carers are very good,” “They are very good, very caring and always respectful”, “I am well cared for, they know how I need help” and “We are one big happy family.” Relatives told us they were fully involved in the planning and review of their family members support needs.. Two relatives told us they had experienced other care providers before and were not positive about their experience. However both stated they would recommend Duchy Care. One said “This is my second time of receiving care, I would recommend them to people as they have restored my faith.”

People told us they had ‘never’ experienced a missed care visit. The registered provider said “Missed visits are not an option. People in the community are vulnerable and we must and do visit when we say we will. It’s not acceptable for visits to be missed.” The service had robust and effective procedures in place to ensure that all planned care visits were provided.

We found people’s visits were provided on time, staff visit schedules included appropriate travel time and staff consistently provided the care visits of the correct visit length. People told us staff supporting them were on time. They were never rushed and staff stayed for the correct duration of their visit. People said it was “rare” that staff were late, commenting, “If they are late, they call us to tell us they are on their way. It’s understandable why they are late because they get held up at their last visit because of an emergency or because of traffic.” They also said “Sometimes they stay over their time if they don’t finish their job, they don’t rush me.”

The service’s visit schedules were well organised and at the time of our inspection visit there were a sufficient number of staff available to provide people’s care visits in accordance with their preferences. This meant people received home visits at their preferred time.

The registered manager was confident about the action to take if they had any safeguarding concerns and had liaised with the safeguarding teams as appropriate. Risk assessments clearly identified any issues and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence.

People said staff were well trained and understood how to meet their specific care needs. Training records showed staff had been provided with all the necessary training which had been refreshed regularly. Staff told us they had ‘lots of training” and found the training to be beneficial to their role.

The service’s systems for the induction of new members of staff were effective and fully complied with the requirements of the Care Certificate. Training was provided in accordance with the 15 fundamental standards. Staff said they were encouraged to attend training to develop their skills, and their career.

The registered provider and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to make sure people who did not have the mental capacity to make decisions for themselves, had their legal rights protected. We found that the service acted in accordance with legal requirements.

People were supported by stable and consistent staff teams who knew people well and had received training specific to their needs. People told us they were introduced to new staff before they supported them in their home and said they had consistent carers to support them and had built up positive relationships with staff. The staff team comprised of male and female carers of differing ages, from 22 years to retirement age. The register