Flexicare South Midlands provides personal care to people who live in their own homes. Forty-eight people were receiving the service at the time of our inspection.

This inspection visit took place on the 10 May 2017 and was announced. The provider was given 48 hours’ notice because we needed to be sure managers and staff would be available to meet with us. At the last inspection, the service was rated good. At this inspection we found the service remained Good.

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.

The registered manager continued to have oversight of the service and to send us statutory notifications about important events at the service, in accordance with the regulations. They had delegated the day-to-day management of the service to a manager, who we refer to as ‘the manager’ throughout the report.

Staff understood their responsibilities to protect people from the risk of abuse. The registered manager checked staff’s suitability for their role before they started working at the service and made sure there were enough staff to support people safely. Staff were trained in managing and administering medicines safely.

Risks to people’s individual health and wellbeing were identified and care was planned to minimise the risks. People were supported to maintain as much independence as possible by being involved in planning their care.

People were cared for and supported by staff who had the skills and training to meet their needs. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were supported to eat and drink according to their preferences and needs. Staff supported people to maintain their health and to obtain advice from healthcare professionals when needed.

The manager and staff understood people’s individual needs and preferences for care and support. Staff knew people well, cared for them as individuals and respected their privacy and promoted their dignity.

People had confidence in the manager’s willingness and ability to deal promptly and effectively with any concerns or issues they raised.

The provider employed staff and managers who shared their purpose and values, which put people at the heart of the service. The management team checked the quality of the service by observing staff’s practice and asking people for their views of the service.

Further information is in the detailed findings below.

We inspected this service on 13 March 2015. The inspection was announced. The service was meeting the Regulations at our previous inspection on 29 November 2013.

The service delivers personal care to people in their own homes. At the time of our inspection 50 people were receiving the service.

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.

People told us they felt safe with all of their care staff. The provider had taken measures to minimise risks to people’s safety. Staff were trained in safeguarding and understood the action they should take if they had any concerns that people were at risk of harm. The registered manager checked staff’s suitability to deliver personal care in people’s own homes during the recruitment process.

Care plans included risk assessments for people’s health and wellbeing and described the actions staff needed to take to minimise the identified risks. Staff understood people’s needs and abilities because they read the care plans and shadowed experienced staff when they started working for the service.

The registered manager assessed risks in each individual person’s home and advised staff of the actions they should take to minimise the risks. People’s medicines were administered safely because the provider’s medicines policy included training staff and checking that people received their medicines as prescribed.

Staff received training and support that enabled them to meet people’s needs effectively. Staff had opportunities to reflect on their practice and consider their personal career development.

The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Records showed that people, their families and other health professionals were involved in making decisions about their care and support. Staff understood they could only care for and support people who consented to being cared for.

Staff referred people to other health professionals for advice and support when their health needs changed and supported people to follow the health professionals’ advice.

Staff were allocated to people within a close geographical area of each other to ensure the amount of time spent travelling did not affect the amount of time available for care and support. Staff had regular rounds so they got to know people well.

People told us their care staff were kind and respected their privacy, dignity and independence and became ‘part of the family’.

The provider asked people about their preferences for care during their initial assessment of needs. People told us they received care from a regular team of staff who understood their likes, dislikes and preferences for care.

People knew their complaints would be listened to and action taken to resolve any issues. Records showed the provider made improvement to the service in response to complaints.

People were encouraged to share their opinions about the quality of the service with through telephone conversations, visits by the management team and regular questionnaires.

The staff and management team shared common vision and values about the aims and objectives of the service. People were supported and encouraged to live as independently as possible, according to their needs and abilities.

The provider’s quality monitoring system included regular checks of people’s care plans and staff’s practice. When issues were identified the provider took action to improve the quality of the service people received.

As part of our inspection we spoke with five people who received domiciliary care from Flexicare South Midlands and representatives of six others. The people we spoke with were satisfied with the service and most were very pleased with it. One person who used the service described it as, “Brilliant”. A relative told us that the care workers were, “Jolly, friendly, efficient and punctual.”

We found that people’s needs had been assessed and care plans had been developed based on their needs, helping to ensure people received appropriate care. Risks had been identified and measures put in place to minimise risks to people who used the service.

People who used the service told us that care workers were respectful and polite and they felt safe with them. We found that care workers were knowledgeable about the needs of the people who used the service, received training and felt supported in their roles.

We found that the service was well managed and people told us that they were very good at responding to any concerns.

We spoke with three people who used the service, one relative and three care staff about the quality of care and support from Flexicare. We also looked at three care plans. People told us they were happy with the care and support they received. They told us that staff arrived on time and wore their uniforms, which included identity badges. People told us that staff were kind and respectful. One person we spoke with said, “Apart from the care, they bring me a pleasant young lady who makes me smile.” Other people said, “Two ladies come, mostly spot on time,” and, “They make me feel special, I know they really care.”

Staff we spoke with told us they enjoyed working for Flexicare. One member of care staff said, “The other staff are really helpful, really good, there’s always someone there for support.” Another member of care staff told us, “It is very open here, you can speak your mind. There is nothing to improve, it’s a good company to work for.”

The care plans we looked at were detailed and included clear instructions for staff. Care was planned according to people's abilities and identified risks to people health and well being. Care and support was delivered in a way that supported people to maintain as much independence as possible.

The provider took steps to minimise risks to people and staff. Confidential records were up-to-date and kept securely.

We visited the agency office on 28 October 2011. This was the first inspection visit to this service following their registration in 2010.

We spoke with the provider, a care supervisor and a care staff member on the day of the visit and with three people who use the service and their home carers following the visit, to find out their views and opinions of the agency. We were told that there were currently 17 people using the service.

We looked at two care files to see the care plans and assessments of the person's needs. We wanted to see if the plans were sufficiently and clearly detailed to guide staff to meet the needs of people receiving care from the agency. We also wanted to ensure that the care plan reflected the individual and personal needs of people so that they were able to receive good, safe care. We also wanted to see that people were enabled, where appropriate, to remain independent.

The care plans seen were very detailed and reflected people's personal requirements. We also saw that staff were reminded to ask the person about what they wanted and include them in their care planning. One care plan seen stated "Always give choice."

We spoke with care staff about the training and supervision offered by the organisation, to ensure that they had the skills required to care for people appropriately. Staff told us that they received regular supervision sessions both on a 1-1 basis in a formal meeting and observation of their practice in people's homes. They said that they had received a thorough induction when starting at the agency and had attended regular training sessions.

People spoken with told us care staff stayed long enough to do everything they needed without having to rush. One person told us " I am very satisfied." Another said they offer "very good care."

People told us they had regular care staff visit them, who generally arrived at the expected time, but that if there was a problem the office always contacted them to explain.

The agency had procedures in place to make sure people who used the service should be safe. Staff confirmed that they had attended training in protecting people and understanding what was meant by 'abuse'. Records seen showed that the organisation checked that staff were appropriate to work with vulnerable people before they started work.

People we spoke with told us they had information about making complaints and would talk to the carers or the staff in the office if they were unhappy with anything. They added that they had not had to complain.

The agency had procedures in place for monitoring the service they provided. This should ensure that any problems are identified and improvements where required made.