About the service:

This service is a domiciliary care agency which provides personal care to people living in their own homes. At the time of our visit 49 people were being supported by Elite Social Care Limited.

People’s experience of using this service:

People were overwhelmingly positive about the service they received and said the service was exceptionally caring. People told us staff were very thoughtful and considerate and went above and beyond anything they expected. The relationships between staff and people who received support consistently demonstrated a high regard for people's dignity and respect.

The service was highly effective. We were repeatedly told staff made a difference and promoted a good quality of life for people.

People were actively empowered to take control of their care packages and to lead the lives of their choosing. Care records we looked at contained evidence the person supported had been involved with and were at the centre of developing their care plans.

People’s independence was actively promoted giving people greater confidence and boosting self-esteem. People told us staff had enabled them to regain skills they thought they had lost.

The service demonstrated an extremely compassionate awareness and understanding to end of life care. We received feedback from a Macmillan nurse who told us staff and management at Elite Social Care Limited had been exemplar.

The registered provider and management team worked extremely effectively and proactively together. We found they were excellent role models in the provision of high care standards. There was a positive leadership style which focussed upon dignity, independence and empowerment for both people supported by the service and staff.

The service worked in partnership with other organisations to make sure they followed current practice, providing a quality service and the people in their care were safe.

Rating at last inspection:

Good (13th August 2016)

Why we inspected:

This inspection was a scheduled comprehensive inspection based on the previous rating.

Follow up:

The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

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

The inspection took place on 13 and 15 July 2016 and was announced.

Elite Social Care Limited is registered to provide personal care to people living in their own homes. There were 30 people using the service on the day of our inspection.

A registered manager was in post and was present during our inspection. 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 been trained in how to keep people safe from abuse. They knew what to look for and how to report any concerns to a senior staff member or the registered manager. The provider encouraged people to raise any concerns about their safety and wellbeing, and people felt confident about bringing forward any concerns or complaints. The provider had assessed, recorded and put plans in place to manage the risks to individuals with their involvement.

The provider monitored any incidents, accidents or near misses on an ongoing basis, in order to minimise the risk of these things happening again. They followed safe recruitment practices.

The provider had systems in place to ensure that people received their medicines safely with the support of trained staff. Staff had the necessary skills and knowledge to carry out their roles and to meet people’s individual needs. They underwent an induction, benefitted from an ongoing programme of training and had regular one-to-one sessions with senior staff or the management team. Staff had been trained in the Mental Capacity Act 2005 and sought people’s consent before carrying out care tasks. They supported people to have enough to eat and drink and assisted them in seeking professional medical advice and treatment where needed.

Staff knew people well and treated them with kindness and compassion. They respected people’s right to privacy and dignity. People were involved in care planning and decisions that affected them. Their wishes and preferences were recorded, understood and respected by staff. The provider encouraged people’s feedback on the service and acted on this.

The registered manager promoted a positive culture within the service. People and staff found the management team approachable and felt listened to and involved.

Staff benefited from consistent management and leadership. The provider had developed and made use of quality assurance systems to check the quality and safety of the service provided and to identify areas for improvement.

We considered our inspection findings to answer the questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found.

Is the service safe?

Staff provided care to people in their own homes and ensured that they worked in a safe and hygienic way using appropriate protective clothing. There were enough staff to meet the needs of the people we saw and a member of the management team was available on call in case of emergencies.

Staff personnel records contained all of the information required by the Health and Social Care Act. This meant the provider could demonstrate that the staff employed were suitable and had the skills and experience needed to support the people living in their home.

The registered manager and the staff we spoke with understood the importance of safeguarding vulnerable adults, could identify potential abuse and knew how to report any incidents of abuse.

Is the service effective?

People told us that they were happy with the care that had been delivered and their care records were up to date and signed by them. One person said : “These girls are very particular; they check all areas for any pressure sores.” A relative said: “They support me too.”

Care records confirmed people’s preferences, interests, needs had been recorded and care and support had been provided in accordance with people’s wishes. One relative said : “We are very pleased with the care we are getting.”

We heard that information was shared very effectively between staff using a number of different methods including calls from the manager, weekly newsletters and staff meetings.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One relative said: “They are great with her.” One person using the service said : “I love them to bits. They are like my family.”

Is the service responsive?

People’s needs had been assessed before they received care from the care workers. People's needs were carefully described so that care workers knew exactly what tasks to undertake. Any change in people's care needs was reported to the registered manager and they briefed other care staff before they visited.

Where complaints were received the registered manager reviewed the service to make improvements. For example a complaint about call times led to a change in the rotas so that care workers called at times best suited to people's needs.

Is the service well-led?

Staff had a good understanding of the culture of the service and quality assurance processes were in place. People told us they had received customer satisfaction surveys but often contacted the registered manager by telephone if they had any concerns. They told us that they found the registered manager : “Very approachable.” Staff told us they were clear about their roles and responsibilities and were: “Genuinely happy.” One person said : “We get lots of support; he is very good to us.”

People were very positive about the service provided by the agency. They told us that staff were, "very pleasant", "very helpful" and "absolutely brilliant". People said that staff treated them with respect.

Records showed that people were involved in planning and reviewing the plans for their care and support. People told us that they were very happy with the standard of care they received.

Staff received a range of training to give them the skills and knowledge they needed for their work. Senior staff checked to make sure that care was given to a high standard.

There were effective systems in place to monitor the quality of the service. People knew who to contact if they had any concerns, and were confident that these would be resolved promptly.

We spent time at the agency’s office, reviewing records and speaking with office staff and the manager. We spoke with four people who use the service and with staff members by telephone. People were very positive about the service they received from the agency, and told us “I can’t fault them”, "I wouldn't consider going anywhere else", and “I would recommend them to anyone”.

People told us that senior staff from the agency kept them well informed. They told us that staff were respectful and kind. They described the staff as “a fantastic bunch of people” and “very polite, very helpful”. People told us that staff were punctual and that they were always informed of any delays.

Care plans were detailed and informative, with sufficient information about people’s care needs for staff to refer to. This meant that staff knew the care and support that each person needed.

The systems for ensuring that medicines were being managed safely were generally effective.

There were effective recruitment and selection processes in place. This meant that the agency was only employing staff who were suitable for working with vulnerable people.

Records were stored securely and staff understood the importance of confidentiality.

We spoke to some people who use the agency, and they were all positive about the care and support they receive from the staff. They told us “they do things the way I like them done” and “you feel they’re there if you need them, but they don’t push themselves where they’re not needed”.

The agency was ensuring that people were treated with dignity and respect. People were encouraged to make choices about how they would like their support provided. People’s care needs were being met by staff with the skills and knowledge to carry out their roles. Care plans were detailed and informative, and were regularly reviewed and updated as people’s needs changed.

The manager and staff understood their responsibility to protect people from the risk of abuse or neglect. The agency had effective recruitment and selection procedures, which helped to ensure that only suitable people were employed.

The agency was making sure that people’s views were used to improve the service. There were effective systems in place to identify, assess and manage risk.