This inspection visit took place on 03 July 2018 and was announced.

Guardian Homecare (Blackpool) is a domiciliary care agency providing personal care to people in their own homes. The agency provides support to people living in the general community and to people living in supported living houses. People in the supported living houses receive continuous care which aims to promote their independence. The service provides support to people with a range of needs including older people and people with physical and learning disabilities. The agency operates from premises based on Amy Johnson Way in Blackpool. At the time of our inspection visit Guardian Homecare (Blackpool) supported 85 people in the community and 25 people in five supported living houses.

At our last inspection on 07 and 08 June 2016 we asked the provider to take action to make improvements because we found a breach of legal requirements. This was in relation to staff recruitment. The service was rated Good overall during the inspection. At this inspection we found the provider had made improvements to ensure they met the legal requirement. We found their recruitment procedures were safe and the evidence continued to support the rating of Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was 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.

We spoke with10 people supported in the community. They told us staff who visited them were polite, friendly and caring. They told us they received patient and safe care and they liked the staff who supported them. Comments received included, "I like all my carers they are all very friendly and helpful.” And, “Good time keepers, friendly and caring. I rely on their help so much.”

Four people living in two supported living houses we visited told us they were happy, safe and liked the staff who supported them. One person said, “The staff are great they look after me.”

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff knew people they supported and provided a personalised service. Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

Staff spoken with and records seen confirmed a structured induction training and development programme was in place. Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

The service had safe infection control procedures in place and staff had received infection control training. Staff had been provided with protective clothing such as gloves and aprons as required. This reduced the risk of cross infection.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible

This inspection visit took place on 07 and 08 June and was announced.

At the last inspection on 10 January 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Guardian Homecare Blackpool is a domiciliary care agency providing personal care to people in their own homes. The service provides support to people living in the general community and to people living in supported living services. People in the supported living services receive care which aims to promote their independence. The service provides support to people with a range of needs including older people and people with physical and learning disabilities. The service operates from premises based on Amy Johnson Way in Blackpool. At the time of our inspection visit Guardian Homecare Blackpool provided services to 116 people.

There was 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.

We looked at the recruitment of three recently appointed staff members and found checks including a a Disclosure and Barring Service check (DBS), and references had been undertaken before they commenced their employment. However none of the applicants provided a full employment history on their application form. There was no evidence this had been discussed at interview or a satisfactory written explanation of the gaps sought. This was a breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) 2014.

Newly appointed staff received induction training completed at the services office base over a five day period. This was followed by shadowing experienced colleagues until they felt safe to support people unsupervised. Staff spoken with told us the training covered everything they needed to know.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

We visited three houses where people were supported by the service. We saw staff had a good relationship with the people in their care. People supported in their own homes told us they were happy and liked the staff who visited them.

Staff knew the people they supported and provided a personalised service. Care plans were in place detailing how people wished their care to be delivered. People told us they had been involved in making decisions about their care.

People supported by the service told us staff who visited them were polite, reliable and professional in their approach to their work. Comments received included, “I have the same group of staff who know what they are doing.” And “I get on with my carers who are punctual.”

People we spoke with told us they felt safe. They told us they received patient and safe care and they liked the staff who supported them. They said staff were respectful, friendly and conscientious.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care being provided.

Staff responsible for assisting people with their medicines had rec

One person who used the service said that the staff were very helpful, and had always treated them in a nice way. “The staff listen to me, and ask me what I want to do. They help me to do the things that I like, and understand that sometimes I need help.” Another person we spoke with said "The staff are great. They always treat me with kindness when bathing me and helping me dress. They are like friends, and talk to me in that way."

The manager told us questionnaires were sent out annually to clients and their carers to complete. These ask for the views on the service and how they feel it could provide a better service. The manager said, "We analyse these surveys and act upon any issues that arise to improve our service." The evidence to support this was seen, and it showed that the service had put measures in place to ensure service users were promptly informed of any changes to the carers who would be attending to their personal care. The manager explained that as the care needs of people living at home has become increasingly complex, training staff to enable them to work effectively with people was very important to the service. Specialist training to meet the particular care needs of people with certain conditions was found to be an important element of the training offered to staff, and the service has a new business plan in place which will allow staff and managers to better coordinate the two strands of the care provided. ie supported living and domiciliary care.

We spoke with a range of people about the agency. They included the registered manager, staff members and people who use the service. In addition we had responses from external agencies in order to gain a balanced overview of what people experienced at Guardian Homecare.

People who use the service told us they were happy with the support they received. One person said, "Guardian provides an excellent service. I am very happy with my carers.”

People told us they had received a visit from a representative from the agency before the service commenced. They 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 also visited one of the houses where Guardian provided a supported living service. This helped us to observe the daily routines and gain an insight into how people's care and support was being managed. We observed staff treated people with respect and dignity.

We spoke to a number of people using the agency who were satisfied with their care:

" I have praised staff when needed. One stayed with us when my relative wasn't well and we needed an ambulance. I praised the staff member for that".

"If I needed to I would contact Guardian about things that concerned me. I am happy with them, no complaints".

"I would tell staff if I am not happy, I like my support staff they help me to go out to town and we do things together".

" I like my staff, I couldn't do without my support workers".

"Staff are regular, nice, caring and respectful. We have had the service for over four years. They are marvellous, I couldn't do without them".

People who use the service told us they mainly received the care they need from staff who knew them and were able to provide the support they required. People told us they had been able to raise concerns with the managers of the agency and these had been listened to and action had been taken to improve the service they received.

People said,

“All in all they’re very good”

“The staff are very good and do everything we ask for. They treat us and our home with respect.”

“A senior member of staff came last week to ask what we thought of the service and if there was anything we wanted to change.”

“One of my carers really is marvellous”

“The staff who come now are a Godsend”

The local authority told us they were concerned that some people had not been protected due to the service not following procedures properly.