This inspection was announced and was carried out on 15, 18 and 19 July 2016. We gave the registered manager short notice of the inspection because we needed to make sure they and staff would be available to speak with us. Genuine Care homecare is a home care agency situated in the town of Edenbridge. The service provides care and support to adults in their own homes through scheduled appointments and through the provision of live-in care staff. The service supports older people, people with physical disabilities and people who are living with dementia. The service does not provide care for children. The agency covers Edenbridge, Sevenoaks, Biggin Hill and surrounding areas.

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 provider was also the registered manager of the service.

People were safe when using this service. Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to report any concerns. Risks to people’s wellbeing were assessed and action taken to reduce these. The service focused on keeping people safe whilst promoting their independence. People were supported to manage their medicines in a safe way. Staff responded quickly to changes in people’s health and worked with other health care professionals to meet their needs. People were given support and advice to ensure they could prepare and eat a varied and healthy diet.

There were enough staff to meet people's needs and staffing levels were flexible according to people’s changing needs. The registered manager followed safe recruitment practices to ensure that staff were suitable to work with people. Staff were qualified and received training that helped them to deliver a high quality service to people. The registered manager provided support and guidance to staff to ensure they were equipped to carry out their roles. Staff felt valued by the registered manager and supported in their roles.

People were asked to consent before any care was given. Where people had difficulty making decisions the principles of the Mental Capacity Act 2005 were followed to ensure people’s rights were protected. People were involved in planning their care and their views about how this should be delivered were recorded and respected. Clear information about the service, the management, the facilities, and how to complain was provided to people. Information was available in a format that met people’s needs.

People told us that the staff were extremely caring. Staff communicated effectively with them, responded to their needs promptly and treated them with kindness and respect. Staff knew people well and were exceptional at delivering care that made people feel valued. The service regularly went above and beyond the agreed care package to deliver sensitive and caring support to people. They had enabled people to access their local community and do things they had previously been restricted in doing. The registered manager was passionate about promoting person centred values as the basis of the service and ensured these were followed consistently by staff. The staff understood the importance of ensuring people’s emotional needs were met as well as their physical needs. Staff had been trained, through the local hospice, to provide sensitive and compassionate care for people who were reaching the end of their life.

People’s privacy was respected and people were supported in a way that respected their dignity and independence. The staff promoted people’s independence and encouraged them to do as much as possible for themselves. Staff understood that people’s needs could fluctuate daily and

The inspection was carried out by one inspector. When we last inspected in July 2014 we found the service was non compliant with the Regulation 21 of the Health and Social Care Act 2008 regarding the requirements relating to workers. This is because some personnel files were incomplete and there was not an effective system in place to carry out criminal checks for staff from abroad.

The service had provided us with an action plan to demonstrate how they planned to remedy this within a time frame. During our inspection, we found that this plan had been implemented and that the situation had been remedied.

We spoke with the manager, the operation director and the senior care manager. We looked at the recruitment process, six sets of personnel files, staff training records and the service's policies and procedures.

During this inspection, the inspector focused on answering our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that people who used the service were protected from the risk of abuse because all care staff were trained in the safeguarding of vulnerable adults and in the principles of the Mental Capacity Act 2005. All staff had been subject to Disclosure and Barring Services (DBS) checks and criminal checks from their country of origin before they started work. The service ensured that staff were of good character, suitable for the job and that they were entitled to work in the UK.

Is the service effective?

We found that the staff had received the training they required to meet the needs of people who used the service and that additional training was available. There was a robust recruitment process that followed legal requirements.

Is the service caring?

We found that people who used the service were supported by kind and attentive staff. Two people who used the service told us the staff were “Quality staff” and “Well trained, polite and friendly”.

Is the service responsive?

A member of staff told us, “There is so much support available and the manager really cares about the staff". Staff's practice was regularly observed and monitored to check good care practice was maintained and to identify whether additional training or refresher courses were needed. The manager told us, “The staff’s problems are our problems and we respond to them immediately”.

Is the service well-led?

We found that the registered manager had a system of quality assurance in place to identify how to improve the service. Spot checks were carried out to ensure that staff maintained good practice. People and their relatives or representatives were regularly consulted about their level of satisfaction. We saw the service operated an 'open door' policy where staff were encouraged to express their views. One member of staff told us, "I love this job. There is an excellent communication in the office and it is a pleasure to work in such a caring environment”.

The inspection was carried out by one inspector over seven and a half hours. We also spoke with four people who used the service, six staff and six relatives as well as the registered manager and director of operations.

At the time of our inspection the service provided support to 50 people who received support with their personal care.

The inspector gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? The inspector gathered information from people using the service and their relatives by telephoning them.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures are robust and staff understood how to safeguard people they supported.

People told us that they felt their rights and dignity were respected.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The staff rotas took into account people’s care needs and the health and wellbeing of staff. We saw that people who required support using specialist equipment had two staff allocated to assist them. This ensured that their needs were met.

Recruitment policies and procedures were in place. People who used the service were involved in the interview process where this was possible. However, checks that should have been completed before staff started working for the service were not always carried out. References from the most recent employer had not always been taken up and steps had not been taken to identify the reason for gaps in employment

We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to checks and documentation required before staff start working at the service.

Is the service effective?

People’s health and care needs were assessed with them, and they were involved in writing their care plans. When specialist needs had been identified, staff had received training in these areas. We found that care plans were up to date and reflected people’s current needs.

People told us that they could contact the registered manager when needed and that they were listened to.

Is the service caring?

We spoke with people who used the service. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example; “Devoted carers”, “They are not clock watchers”, “Caring carers”.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were identified, the service responded to address any issues.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People knew how to make a complaint if they were unhappy. One person said that they had made a complaint and were satisfied with the outcome.

The service worked well with other agencies and services to make sure people were safe and protected from harm.

Is the service well-led?

The service has a quality assurance system, and records showed that problems that were identified were addressed promptly. When opportunities to make improvements were identified they were acted on.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service. Staff said that they felt well supported and the registered manager was always contactable if they needed help or guidance. This helped to ensure that people received a good quality service at all times.

We spoke with seven people who were using the service or who were speaking with us on behalf of a person using the service. No adverse comments were made by any of these people about the quality of the service provided. One person told us that, “…everything was good. No complaints. Without them (the service) I couldn’t have managed”. Another described the service as, “fantastic!” and told us they looked forward to carers visits.

We found the service provided people with information they needed to make an informed choice to give or withhold consent in regard to care, treatment and support provided. People using the service told us that carers had respected their choices about how they were supported.

People told us that they had had the opportunity to discuss with the service their care needs, how these would be met and about their experience of receiving the service provided. We found the service had suitable systems in place to assess and monitor the quality of service provided.

We found that people using the service had been given information about how to make a complaint should they need to do so. People using the service told us that issues shared were treated seriously and quickly resolved.

We spoke with three people who used the service and three relatives of people who used the service. They said that their care and support was always discussed with them and they had a plan of care.

People told us that they were very happy with the care and support that they received. Two people said that the staff were good, “the staff were very nice and caring”. Two relatives of people who used the service said, “The staff go over and above in what they do and they said “the staff were brilliant”.

People told us that their privacy and dignity was promoted. They said that the staff were polite. One person said “The staff are excellent”. Another person said “the staff are helpful and friendly”.

People told us that they always received their visits, staff arrived on time and they stayed for the agreed amount of time. People said if the staff were running late they were informed.

People told us that were asked for their views and they felt listened to. They told us that would feel confident with raining any concerns with the agency. A relative of a person who used the service said, “The manager works hard to provide a good service and has been consistent in providing good care”.