We inspected Greigcare on 6 November 2018 and the inspection was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community in Banbury and the surrounding areas. It provides a service to older adults some living with dementia, disabilities, sensory impairments and mental health needs. Not everyone using Greigcare 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. On the day of the inspection the service was supporting 73 people.

There was 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 last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

The service continued to provide safe care to people. People told us they felt safe receiving care from Greigcare. Staff had received training in safeguarding adults and understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place, these included completing checks to make sure new staff were safe to work with vulnerable adults.

Staff demonstrated they understood how to keep people safe and records showed that risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely and people received their medicines as prescribed.

People continued to receive effective care from staff who had the skills and knowledge to support them. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health. People were supported to meet their nutritional needs.

The service continued to provide support in a caring way. People benefited from caring relationships with staff who treated them with dignity and respect. People were involved in their care and supported to remain independent. The provider had processes in place to maintain confidentiality.

The service continued to be responsive. People received personalised care by staff who understood people's individual needs and preferences. People's changing needs were responded to appropriately. The service was flexible and supported people to attend social events and prevent social isolation. People knew how to complain and complaints were dealt with in line with the provider’s complaints policy.

At our last inspection of Greigcare on 19 May 2016, we rated the service as requires improvement in well-led. At this inspection we found the service had improved to good in well-led because, people told us the service was well managed. People knew the management team and spoke positively about them. The service sought people's views and opinions and acted upon them. The registered manager and management team promoted a positive, transparent and open culture. Staff told us they worked well as a team.

The service had effective systems to assess the quality of care the service provided. Learning was identified and action taken to make improvements which improved people's safety and quality of life.

We undertook an announced inspection of Greigcare Limited on 19 May 2016.

Greigcare Limited provides a domiciliary care service to people in their own homes in the Banbury and Oxfordshire area. On the day of our inspection 105 people were receiving a personal care 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.

The service had systems to assess the quality of the service provided. However, the service did not always analyse data to look for patterns and trends. Accidents and incidents were recorded but we could find no evidence they were fully investigated to allow the registered manager to reduce the risk of reoccurrence.

People told us they were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

People received high quality care that was personalised and met their needs. People were supported by staff who were knowledgeable about people’s needs and provided support with compassion and kindness. Staff actively promoted people’s dignity and respect.

Where risks to people had been identified risk assessments were in place and action had been taken to manage the risks. Staff were aware of people’s needs and followed guidance to keep them safe. People received their medicine as prescribed.

There were sufficient staff to meet people’s needs. Staffing levels and visit schedules were consistently maintained. People told us staff were rarely late and they had not experienced any missed visits. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Staff understood the Mental Capacity Act (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected.

People told us they were confident they would be listened to and action would be taken if they raised a concern. The service sought people’s opinions through regular surveys and visits by the management team. Staff learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the registered manager. Staff received regular supervision. Supervision meetings were scheduled throughout the year as were annual appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.

People told us the service was friendly, responsive and well managed. People knew the managers and staff and spoke positively about them. The service sought people’s views and opinions and acted upon them.

A single inspector carried out this inspection. The focus of the inspection was to answer 5 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 staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

People and their relatives told us that they felt safe with the provider’s support. One person told us, "You feel safe.” Another person said “I know I don’t have to worry.”

Staff had received safeguarding training and understood how to safeguard the people they supported. This involved recognition of signs of possible abuse and how to report concerns.

The registered manager set the staff rotas and took people’s care needs into account when making decisions about the numbers, qualifications, skills and experience of staff required on each shift. This helped to ensure that people’s needs were met.

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

Staff knew about risk management and we saw examples of this in the care plans. People had access to choice and remained in control of decisions about their care and lives.

Is the service effective?

People told us they were involved in their care. One person told us that they had a care plan which staff looked at before giving care. They said “I tell them what to do.” People’s health and care needs were assessed with them, and they were involved in writing their care plans. People said that their care plans were reviewed and reflected their current needs.

Is the service caring?

We spoke with eleven people or their relatives who were being supported by the service. We asked them for their opinions about the staff that supported them. People said that they valued having visits from regular carers. One person told us their regular carer was “Just like one of the family”.

A carer told us that it was important to ask people’s preferences about their care and “make sure you’re [the person is] happy”.

People using the service and their relatives completed an annual satisfaction survey. This helped to identify good practice and areas for development.

Is the service responsive?

One person told us that “carers are always on time”. Another said “I feel I can depend on them”.

The provider monitored the quality of the service and responded to feedback from people and relatives. People knew how to make a complaint if they were unhappy.

The service worked with other agencies and professionals to make sure people received effective care.

Is the service well-led?

The service had an effective quality assurance and monitoring system, and records showed that identified problems and opportunities to improve the service were addressed. As a result the quality of the service was improving.

Staff told us they understood their roles and responsibilities and that senior staff supported them well.

We spoke with 17 people and their relatives about how people were involved in their care. At the time of our visit 117 people received a service from Greigcare Limited.

People told us they were involved in their care. One person told us, “Yes, he has a care plan and I signed it, we gave our opinions as much as we could”.

Everyone we spoke with was happy with the service they received. One person told us, “I'm very pleased and have got no complaints.” A relative told us, “The girls are fantastic. He's happy. He claps his hands.”

We asked people and their relatives if they felt safe with their service. Everyone we spoke with felt safe. One person told us, "Yes, I feel safe. I've no concerns, no problems".

Care workers received appropriate professional development. We spoke with four care workers. We asked care workers if they had access to training. One care worker told us, “There is always lots of training; we’re supported to complete this”. Another care worker told us, “We all do the mandatory training, but we can access additional training”.

People we spoke with told us they felt able to raise concerns. One person told us, “Definitely, if I needed to, I would (complain). I'd phone one of the offices'”. Another person told us, “I did complain once or twice and they sorted it out for me”. This meant that people’s and their relatives knew how to complain and felt this would be acted on.

People we spoke with told us that they were treated well by staff. They said they were able to make choices about the care and support they received from the agency. They told us that they were involved in the review of their care plans and that changes

were made only if they were in agreement. People told us that they were kept informed of changes to their care plans and could

approach the agency's manager or staff if they were worried or concerned about any aspect of their care.

Staff told us they enjoyed working for the agency and felt they were well trained and supported by the managers. They said that the agency was well organised and that they knew what was expected of them and how to get help and advice if they needed it.

People we spoke with told us that they were treated well by staff. They said they were able to make choices about the care and support they received from the agency.

They told us that they were involved in the review of their care plans and that changes were made only if they were in agreement.

People told us that overall they were happy with the service provided. Some people told us that if their care staff were caught up in traffic or had been delayed at the previous call they were sometimes late. People we spoke with told us if their care was going to be very late, usually 15 minutes or more, they would be contacted by the agency.

People told us that they were kept informed of changes to their care plans and could approach the agency’s manager or staff if they were worried or concerned about any aspect of their care.

The agency kept in contact with them and the manager and senior staff sometimes arrived unannounced to check on their care.