E.C.H.O. Care Limited is a small domiciliary care agency located in Horsham. It provides personal care and support to adults with learning difficulties and complex behavioural needs primarily in a supported living or shared housing environment. The agency also provides a service to people in their homes within the Horsham and Crawley areas. At the time of our inspection the service was providing care and support to 23 people.

At our last inspection in April 2016 we rated the service Good. 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 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.

The service met all relevant fundamental standards.

The service had a positive culture that was person-centred, open and inclusive. There was a strong emphasis on putting people first. People had individual plans of care and risk assessments.

It is a requirement of the provider's registration that they have 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. The service had a registered manager in place. It was well led, and the registered manager was aware of their legal responsibilities.

Staff were enthusiastic and keen to talk about their role. Staff were proud of the service and their work. They felt supported within their roles and held the management team in high regard. Recruitment practices were robust, and staff received training appropriate to their role and the needs of the people living at the service.

Further information is in the detailed findings below.

Echo Care Limited is a small domiciliary care agency located in Horsham. It mainly provides support to adults with learning difficulties and complex behavioural needs primarily in a supported living or shared housing environment. The agency also provides a service to people in their homes. Echo care also provides a domiciliary care service for older people with a range of physical and mental health issues.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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 was a manager for each of the services; the supported living service for people with learning disabilities and the domiciliary care service for older people whom the registered manager managed.

People told us they felt safe and were happy with the support they received from Echo Care Ltd. One person told us “I feel safe; staff are confident, pleasant and friendly”. Another person said “I feel safe, I know the staff well and they help with day to day stuff”. People were safe as they were supported by staff that were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. Medicines were managed and administered safely. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the manager.

We saw people were supported by staff that knew them well, gave them individual attention and looked at providing additional assistance as and when required. People were at the centre of their care and staff and the management team promoted this ethos and culture.

The service was well led. There were systems and structures in place to capture people’s feedback and to ensure the quality of the care and support provided.

Staff, the registered manager and locality managers were knowledgeable about the Mental Capacity Act 2005. They were aware this legislation protected the rights of people who lacked capacity to make decisions about their care and welfare.

The staff team were responsive to people’s social needs and supported people to maintain and foster interests and relationships that were important to them. People were central to the practices involved in the planning and reviews of their support. People were encouraged to be as independent as possible.

People received regular assessments of their needs and any identified risks. Records were maintained in relation to people’s healthcare, for example when people were supported with making or attending GP appointments.

People told us that staff were kind and caring. One person said “Staff are really nice, they help me”. Another person said “Staff are definitely kind and caring and I look forward to them coming”. We observed staff treating people with dignity and respect and involving them in their care. People told us they were treated with dignity and respect and supported to be as independent as possible. We observed this to be the case.

We were informed that, at the time of this inspection, 15 people received personal care in their own homes from the service. We spoke with one person and the relatives of three others. This was by telephone after we had visited the office.

People and relatives we spoke with confirmed they were happy with the care and support that had been provided. One person told us, "I have been using Echo Care for about a year. I have never been let down by them. The care workers are so caring and patient." A relative commented, “The care my relative has received has been provided courteously and lovingly.” Another relative said, “The care workers have been mostly brilliant. When we had a problem with one care worker we reported it to the office. It was dealt with correctly.”

We also spoke with two care workers by telephone. They demonstrated that they had a good understanding of their roles and responsibilities. They were also knowledgeable about the individual needs of each person they visited to provide care.

We also gathered evidence of people's experiences of the service by looking at a selection of records. They included care records and care workers’ training and supervision records. We found that the records we looked at were up to date and well maintained. They also ensured people received care that was safe, appropriate and in accordance with individual wishes and needs.

We asked about the agency’s systems for monitoring the quality of the service provided. We were given evidence that demonstrated people had been consulted and included when the care provided had been reviewed. However, the provider was unable to demonstrate how adverse events, incidents, missed calls, comments and complaints had been audited and monitored.

As part of this inspection we carried out telephone interviews with people who used the service and family members. We spoke with three people who received a service from the provider and three relatives of people who were unable to speak to us directly. Their comments were very positive. All felt that they were treated with respect and their dignity had been maintained at all times. People told us the care and support was consistent and delivered in a manner that met their expectations.

One person said, "They do everything I ask of them, they are caring and sympathetic. These are the best carers I have had"

A family member said, "We have had a very good experience of using this agency, it could not be better."

We spoke with the three staff members currently employed by the provider. They told us that they felt supported to carry out their work. Staff told us they were supported to understand their role through induction training and shadowing colleagues on visits.

We did not speak to any of the people who use the service due to their complex behavioural needs. However we received feedback from relatives on behalf of the people who use the service.

All feedback we received was positive. We were told that staff knew the people who use the service well and were aware of their complex needs.

People we spoke with told us they were involved in making decisions about the level and type of support received. They felt the staff always respected people’s privacy and dignity and that the staff helped them to maintain or regain as much independence as possible.

People told us that the service provided by ECHO Care Limited was of a high standard. One relative told us that the service was brilliant and that their son loves it.