The inspection of Fylde Community Care was carried out on 20 and 21 November 2017 and was unannounced on the first day.

This service is a domiciliary care agency. It provides personal care to people who live in their own homes. It provides a service to older people and those who may live with dementia, mental health conditions, physical disability and sensory impairment. The agency is situated in St Annes. At the time of our inspection there were 35 people receiving a service from Fylde Community Care.

We last inspected the service in October 2016, when we found the service was not meeting legal requirements in relation to the safe recruitment of staff. During this inspection, we checked what improvements had been made and found the provider was meeting legal requirements.

The registered provider had procedures around recruitment and selection to minimise the risk of unsuitable employees working with people who may be vulnerable. Required checks had been completed before any staff started work at the service.

The service had 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.

During this inspection, we found staff had received training to safeguard people from abuse. They understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of adults who may be vulnerable.

There was an appropriate skill mix of staff to ensure the needs of people who used the service were met. New staff received a comprehensive induction and worked alongside experienced staff members whilst they learnt their role.

The registered provider planned visits to allow carers enough time to reach people and ensure their care and support needs were met. New clients were not taken on unless the service had capacity to do so at the times people required support.

Care plans were organised and had identified the care and support people required. We found they were personalised and informative about the care people received. They had been kept under review and updated when necessary. They reflected any risks and people’s changing needs.

Staff responsible for assisting people with their medicines had received training to ensure they were competent and had the skills required. Senior staff completed spot checks on care staff to observe their work practices were appropriate and people received care that was safe.

Staff were provided with personal protective equipment to protect people and themselves from the spread of infection.

The registered provider used a range of methods to assess, monitor and improve the quality of the service provided. They were looking to introduce further formal methods following our inspection.

Staff members received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their the care and support they required. Staff told us they felt well supported by the management team.

People told us they were involved in their care and had discussed and consented to their care packages. We found staff had an understanding of the Mental Capacity Act 2005 (MCA).

When appropriate, meals and drinks were prepared for people. This ensured people received adequate nutrition and hydration.

Care records contained information about the individual’s ongoing care and health requirements. This showed the registered provider worked with other health care services to meet people’s health needs.

People said they had a team of regular carers with whom they and had built up good relationships. Staff told us they had got to know people they supported well and had a good level of knowledge

The inspection visit at Fylde Community Care was undertaken on 04 October 2016 and was announced. We gave 48 hours’ notice of the inspection to ensure people who accessed the service, staff and visitors were available to talk with us.

Fylde Community Care provides personal care assistance for people who live in their own homes. The service supports older people and those who may live with dementia, mental health conditions, physical disability and sensory impairment. The office is based in St Annes’ town centre. At the time of our inspection, Fylde Community Care was working with 47 people.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (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.

At the last inspection on 06 February 2014, we found the provider was meeting the requirements of the regulations.

During this inspection, people and their representatives told us they felt safe whilst being supported in their own home. However, the provider had failed to follow required, safe recruitment procedures to ensure staff were suitable to work with vulnerable people. Necessary checks of employees’ background and employment history were not always in place. This is a breach of Regulation 19 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Fit and proper persons employed.

You can see what action we told the provider to take at the back of the full version of the report.

Although a number of audits were undertaken to maintain people’s safety and wellbeing, these were limited and not always completed. For example, staff file audits we looked at did not always contain required recruitment documents.

We have made a recommendation about the provider seeking guidance related to auditing systems.

People who used Fylde Community Care said it was well organised and they felt able to contact them if they had any problems. On person said, “The managers are very obliging. If I need to change things around it’s never a problem.” We found the registered manager sent people questionnaires to gain their feedback and sought ideas from staff related to service improvement.

People said there were sufficient numbers and consistency of staff to meet their requirements. One person said, “I like chatting with them and having the same staff helps with that.” The registered manager provided a variety of training to underpin staff skills and knowledge. This included safeguarding vulnerable people. We discussed with staff how they protected individuals from potential abuse. They demonstrated a good understanding of relevant principles.

Individuals who used the service told us they received their tablets on time and when required. Staff undertook related training and completed records accurately. The management team additionally risk assessed people’s medication to ensure this was managed safely.

Staff received training about the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. A person who used the service told us, “If I don’t want to get up, they don’t force me and offer an alternative, such as a bed bath.” People told us staff were respectful and supported them to make their day-to-day decisions.

We found staff and people who used the service worked together in the planning, review and provision of their care. Individuals who used Fylde Community Care said they were supported to comment about their experiences. Care planning was aimed at helping people to maintain their independence. They told us staff worked with them in a personalised way.

We observed staff approached people’s care in ways that maintained their dignity and self-determination. One person said, “I am confident and reassured by a good service.” The manage

We spoke with a range of people about the agency. They included the director, staff members and service users. We also asked for the views of external agencies in order to gain a balanced overview of the service people received from Fylde Community Care Limited.

People who used the service told us they were happy with the support they received. One person said, “I cannot find fault with the service." Another person told us, “I can’t praise the staff highly enough, they show me nothing but care and kindness.” People told us their needs had been discussed and they had agreed to the support to be provided. They told us their carers provided sensitive and flexible personal care support and they felt well cared for.

We reviewed staff training and supervision records. We saw there were sufficient staff with a range of skills and experience. Staff told us they felt supported, had regular meetings with the provider and their training was kept up to date.

There were a range of audits and systems in place to monitor the quality of the service being provided.

We spoke with a range of people about the agency. They included the manager, staff, relatives and people who receive a service from the agency. We visited family homes of clients and spoke to carers and people who use the service. We also had responses from external agencies including social services. This helped us to gain a balanced overview of what people experienced using Fylde Community Care.

People who used the service gave consent to the care they were to receive. They also gave consent to the way confidential information may be shared with other agencies, on a need to know basis only. One person said, “We went through all the tasks to be done and agreed on the package of care. The girls were very good and I signed the agreement document.”

People told us they had received a visit from a representative from the agency before the service commenced. “Yes the owner came to see me and my wife before the service started.” They told us their needs had been discussed and they had agreed to the support to be provided. People we spoke with told us their carers provided sensitive and flexible personal care and they felt well cared for.

Two people we visited in their home said about the agency, “This is the best service we have had from a care agency. “ Also,”Never had to complain, always do a good job, the staff are very competent in what they do.”

We spoke with relatives (their loved ones were unable to communicate to us easily), people who use the service and members of care staff, as well as the manager and administrator. We received positive feedback and comments including;

“I have used other care agencies before with my husband but have had awful experiences. Fylde is the best I have ever used. Time, attitude everything. They will bend over backwards for you.”

“I feel able to talk to the agency about any problems.”

“I have used them for several years and they are excellent.”

“There is a care plan that I was involved in putting together, that outlines what needs to be done.”

We also spoke with officers from the Local Authority who monitor standards on behalf

of those commissioning the service. They told us that they had no concerns about the agency or the standard of care provided