Everycare (Isle of Wight) 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 to older adults, people living with dementia, people with a mental health condition, physical and learning disabilities, sensory impairments and younger adults.

At the time of the inspection, the service was providing care and support to 79 people. Each person received a variety of care hours, depending on their level of need. The Care Quality Commission (CQC) only inspect the services being received by people provided with ‘personal care’; such as help with tasks related to personal hygiene and eating. Where this is provided, we also take into account any wider social care provided.

Inspection activity started on 26 September 2018 and ended 05 October 2018. This inspection was announced. We gave the provider 48 hours’ notice of our inspection as we needed to be sure key members of staff would be available.

There was a registered manager in place. 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.

At the previous inspection in March 2016, we rated the service as Good in all key questions areas of Safe, Effective, Caring, Responsive and Well-led. At this inspection, we found the information supported the rating of Good, with the key question of Caring which had improved to a rating of Outstanding.

Staff treated people with utmost kindness, respect, and compassion. Staff had built exceptionally positive relationships with people and knew what mattered most to them.

Staff respected people’s dignity and privacy respected at all times and took steps to promote people’s independence where possible.

The service went the extra mile to support people to maintain their interests and achieve their goals and wishes.

People felt safe with staff. People were protected from the risks of abuse and staff were trained in recognising and reporting safeguarding concerns. Safeguarding investigations were thorough and identified learning to help prevent a reoccurrence.

Individual and environmental risks to people were managed effectively. Risk assessments identified risks to people and provided clear guidance to staff on how risks should be managed and mitigated.

The service carried out robust recruitment checks before employing a new member of staff to ensure they were suitable to support people in the community.

People’s needs were met by staff who were competent, trained and supported appropriate in their role. Staff acted in the best interests of people and followed legislation designed to protect people’s rights and freedom.

People were supported to access health professionals and other specialists if they needed them. Procedures were in place to help ensure that people received consistent support when they moved between services.

The service used technology to manage and monitor people’s care within the community, and to keep in contact with people’s relatives.

People’s care was delivery in a personalised manner, in line with their preferences. Care plans contained detailed information to enable staff to provide care and support in a person-centred way.

People knew how to raise concerns, which were listened and positively responded to and were used to make further improvements.

Staff worked in partnership with healthcare professionals to support people at the end of their lives to have a comfortable, dignified and pain-free death.

There were robust quality auditing processes in place. The quality of the service was monitored and appropriate actions were taken when required.

There was a clear vision to deliver person centred care, and enable people to maintain indepe

Everycare (Isle of Wight) is a domiciliary care agency providing personal care to people living in their own homes. These included people living with dementia and people living with a physical disability or a learning disability.

The last inspection of the service took place on 22 and 26 January 2015, where we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We set a compliance action in relation to the management of risks and the establishment of an effective recruitment process. The provider sent us an action plan stating they would be meeting the requirements of the regulations by 01 May 2015.

This was an unannounced inspection, which was carried out on 08, 11, 12 and 14 January 2016. At the time of our visit the service was providing personal care to 70 people. During the inspection we found the provider had completed all the actions they told us they would take.

There was a registered manager in place at the service. 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 using the service and their relatives told us they felt safe. Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided enough information to allow staff to protect people whilst providing care and support.

People were supported by staff who had received the appropriate training, professional development and supervision to enable them to meet their individual needs. There were enough staff to meet people’s needs and to enable them to engage with people and provide care in an unhurried manner.

People and when appropriate their relatives had been involved in the planning and review of their care. Care plans were personalised and reflected people’s individual needs. Staff used the information contained in people’s care plans to ensure they were aware of their needs and how to support them. Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

Staff developed caring and positive relationships with people; they were sensitive to their individual choices and treated them with dignity and respect. People were supported to have enough to eat and drink.

There were suitable systems in place to ensure the safe management and administration of medicines across the service. All medicines were administered by staff who had received appropriate training. Healthcare professionals, such as GPs and district nurses were involved in people’s care where necessary.

There was an opportunity for families to become involved in developing the service and were encouraged to provide feedback on the service provided. The provider had established a safe and effective recruitment process and had arrangements in place to deal with any concerns or complaints.

There was a clear management structure and staff understood the role each person played within this structure. The service had a positive and open culture and the registered manager understood the responsibilities of their role

People told us overall they were pleased with the service. They told us they knew who was coming to visit them and at what time. We were told the staff who called were polite, respectful and treated them with dignity. Most people told us the staff knew what to do when they called. One person told us sometimes when they had new staff they could not always meet their needs and they had to train them. We found no other evidence to support this. People said if they complained their concerns had been taken seriously and investigated.

Everycare (Isle of Wight) is a domiciliary care agency providing personal care for a range of people living in their own homes. These included people living with dementia and people living with a physical disability or learning disability. The inspection was carried out over the 22 and 26 January 2015 and at the time of our visit the service was providing personal care to 60 people.

The last inspection of the service took place on 16 and 20 May 2014, where we identified a breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We set a compliance action in relation to the management and storage of medicines. The provider sent us an action plan stating they would be meeting the requirements of the regulation by 15 July 2014.

This inspection, which was unannounced, was carried out on the 22 and 26 January 2015. During the inspection we found the provider had completed all the actions they told us they would take.

There was a registered manager in place at the service. 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 using the service and their relatives told us they felt safe. However, not all risks relating to people’s health and wellbeing had been identified, assessed and had strategies in place to support staff in mitigating those risks.

The recruiting practices were not robust and did not always ensure there was sufficient information available to prevent unsuitable staff from working with people who used the service.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act 2005 (MCA) which applies to services providing care in the community. Although staff were aware of the principles of the MCA, they did not have access to sufficient information to enable them to understand the ability of a person living with dementia to make specific decisions for themselves.

Care staff developed caring and positive relationships with the people they supported and treated them with dignity and respect. People and their relatives described the care staff as understanding and affectionate.

There were effective systems in place for the management of medicines. Staff completed medicine administration charts correctly. There was a lack of clear guidance available to support staff with the administering of topical creams.

There was a quality assurance structure in place. However, the dip-check approach to auditing files and records adopted by the manager was not robust enough to ensure that errors and omissions were identified.

Staffing levels were based on the assessment of people’s needs. However, the service was not always able to respond appropriately to cover short term absences.

Staff had completed the necessary training to enable them to support people. They were also supported through regular supervisions, which provided an opportunity to discuss any concerns and identify learning and development needs.

Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

People using the service and their relatives told us they felt the service was effective. People were assessed prior to commencing with the service to ensure the service was able to meet their needs.

Staff were knowledgeable about the people they supported and the things that were important to them, such as food preferences. They supported them to have enough to eat and drink.

When necessary staff liaised with other healthcare professionals, such as GPs, district nurses and chiropodists to ensure people received a consistent approach to their healthcare.

The provider had systems in place to promote an open and fair culture. There were structures in place to enable people and staff to comment on the culture of the service and become involved in its development.

The provider sought feedback from people using the service and their relatives in respect of the quality of care provided and had arrangements in place to deal with any concerns or complaints.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.