About the service: Gladstone Care Limited – 54 Gladstone Street is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults who may need support with their mental health, dementia related conditions, learning disabilities or autistic spectrum disorder and physical disability or sensory impairment.

Not everyone using Gladstone Care Limited - 54 Gladstone Street receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At the time of this inspection the provider was supporting 130 people with personal care.

People’s experience of using this service: Quality monitoring was completed regularly. The provider had systems in place to report safeguarding concerns to ensure people’s safety. However, records were not in place to provide an overview of all safeguarding incidents and the actions taken. The provider immediately took measures to develop this system during the inspection.

Risk assessments were completed regularly and provided guidance for staff on how to mitigate any risks to people. Risks associated to people’s health conditions would benefit from further detail to guide staff in how best to support them. The provider took measures during the inspection to include specific care plans around people’s health conditions and ensure detailed risk assessments were in place to support staff.

Staff could tell us about people’s likes, dislikes and preferences. Care plans and risk assessments were being developed to encourage a more person-centre approach.

Staff completed the Care Certificate as part of their induction and completed annual refresher training to maintain their knowledge and skills. The Care Certificate is a national set of standards that all those working in health and social care should adhere to. Additional courses were offered, some delivered by the local hospice and district nurses. Staff were knowledgeable about people’s needs and how best to support them.

Robust recruitment processes were followed to ensure prospective staff were suitable to work in a care environment. Since our last inspection the service had restructured and additional senior staff were in place to support existing staff in the community.

People told us they felt staff cared about them and gave examples of how staff treated them with dignity and respect, whilst encouraging as much independence at possible.

The majority of staff we spoke with told us that they used various methods of communication and felt that overall information was provide to them in a timely manner.

Rating at last inspection: At the last inspection the service was rated Good (Last report published 9 August 2016).

Enforcement: We found the provider to be in breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

Follow up: The provider had failed to notify the Care Quality Commission of safeguarding concerns. This will be dealt with outside the report writing process and the service monitored to ensure future notifications are made appropriately.

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

This inspection took place on the 30 June 2016 and was announced. Gladstone Care Limited - 54 Gladstone Street, provides care and support to people who live in their own homes within the Scarborough and Ryedale area.

The service is registered to offer a domiciliary care service to the following; people who are living with dementia, people with learning disabilities or autistic spectrum disorder, people with mental health needs, older people and people with physical disabilities. However, the majority of care needs were in relation to dementia and physical disability, with a small percentage of people supported due to needs associated with a learning disability or mental health. The service was offering care and support to 188 people at the time of the inspection.

The service had a registered manager. 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 told us they felt safe while staff were supporting them with personal care. Staff told us they were confident that if they had any concerns about people's safety, health or welfare they would know what action to take. This included reporting their concerns to the registered manager or to relevant external agencies.

Potential risks to people were assessed and used to develop plans of care to protect them from harm, while maximising their freedom. Staff had undergone a robust recruitment process and received training and supervision to enable them to meet people's needs in a safe and timely way.

People's needs were met, which included support with meals and drinks when required. Staff liaised with health care services and external agencies where appropriate.

People's choices and decisions were recorded in their care records. Staff gained consent from people before delivering care. Staff promoted the rights and decisions of people, and were aware of the principles of the Mental Capacity Act 2005.

Reviews of care were not consistently recorded. However, people's needs had been assessed prior to them receiving a service and they told us they had been involved in the development and reviewing of their care plans.

People were happy with the care and support they received. They made positive comments about staff and told us they were kind and helpful.

Information was given to people using the service to ensure they knew how to raise concerns or complaints. People told us they were aware of how to raise concerns. Complaints had been addressed and actions had been recorded.

The service responded to people’s individual needs and preferences. Care plans reflected the knowledge staff had of each person, so that they could be placed in the centre of care. Staff were organised into local geographical area teams, which meant that people most often received care from staff they were familiar with and who knew their needs well.

Systems were in place to check the quality of the service provided. The registered manager sought regular feedback from people in order to develop and improve the service. Regular staff meetings were held where staff were encouraged to voice their views. They told us that communication was effective and that they felt supported by the registered manager.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

As part of this inspection we looked at records for six people who used the agency and records relating to the management of the service. We spoke with four people who used the service and two representatives by telephone. We also spoke with five members of staff, including senior staff.

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

This is a summary of what we found:

Is the service safe?

People spoke positively about the care they received and about their carers. People said they knew who to speak to if they had any worries or concerns and were confident that action would be taken if they raised any issues. People told us that they always felt safe when the carers visited them. People said “They (the carers) are brilliant, they come to their time and never rush me and everything is done in my time”. Another person told us “They (the carers) are always polite and they never make me feel uncomfortable”.

People told us that they felt their rights and dignity were always respected. Feedback we saw said “I think Gladstone Care do a great job already. I wouldn’t be able to have my relative living in their own house if not for all your help”. Other feedback included “I would like to thank you all so very much for your kindness, love and caring for my relative”.

Systems were in place to make sure that the manager and staff learnt from accidents and incidents. Audits were being undertaken and people's views were sought. There were policies and procedures in place to deal with any complaints that may arise. This helped to ensure that the service continually improved.

The service had policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were assessed prior to a service commencing and on an on-going basis, this helped to ensure their rights were protected.

Procedures were in place for dealing with emergencies and staff were able to explain these to us.

Is the service effective?

People's files contained assessments, which showed that people's health, personal and social care needs were assessed before care was delivered to them at home. When people were identified as being at risk, their support plans showed the actions required to manage these risks.

People we spoke with confirmed they had a support plan in their home, which was followed by carers when they visited. People said that their support plans were up to date and reflected their current needs. Records we saw supported this.

Staff had received training to meet the needs of people they support in the community. They had also completed mandatory training so that they could work safely with people. Staff we spoke with told us they received very ‘good support’ from the agency.

Is the service caring?

People we spoke with told us that they were well supported by the service. We asked them for their views about the staff that supported them. Feedback from people was very positive. We spoke with four people who were using the service and two people whose relatives used the service. We also checked some of the feedback people had provided. Everyone told us they were satisfied with the care they received and spoke positively about individual care workers. People described carers as being ‘brilliant, caring, helpful, polite and efficient.’

Is the service responsive?

People told us their care workers generally arrived on time and they stayed for the correct length of time that had been agreed. People said if they had any problems they contacted the senior carer who would make sure any issues were sorted out. People told us whenever possible they were kept informed about any changes to the usual care workers who attended to them.

There were robust systems in place to deal with complaints. People told us they knew how to make a complaint.

People we spoke with told us they knew how to make a complaint if they were unhappy. Everyone we spoke with told us they would ring the agency office.

We spoke with the manager, assistant manager and two staff members during our inspection. We also spoke with a person who used the service and two relatives of service users. We examined the care records for four people who used the service and other relevant documentation.

We saw that care needs were discussed with people and/or their relatives and before people received care their consent was asked for. The person who used the service and their relatives told us that they were happy with the care and support they received. They told us that the care workers provided the care they needed, that they protected their privacy and dignity and that they felt safe whilst they were in their home. People told us "Its very good care" and "I’ve no complaints what so ever".

There were effective recruitment procedures in place which ensured staff were employed with the appropriate qualifications, skills and experience necessary.

Staff could tell us who they would contact if they were concerned about abuse. There was a complaints procedure in place at the home. The people we spoke with knew what to do if they had any concerns. The provider had systems in place to assess and monitor the quality of service that people received.

People who use the service and their relatives told us they had positive experiences of the care and support they received. They praised care workers and said they were provided with a reliable service and continuity of care. Their comments included, ‘they are first class, great’, ‘we are very, very fortunate’, ‘they are a godsend, very good’, and ‘we are appreciative of all the help we get’.

Surveys completed by people who received domiciliary care showed they were happy with the service provided. They found the staff friendly and said they were treated with dignity and respect.