The inspection was announced and took place on 25 and 27 September 2018.

Guild Care Domiciliary Care provides personal care and support to people in their own homes. It covers the geographical area along the West Sussex coast from Littlehampton to Southwick. People receiving care had a range of needs such as older people with frailty, people with physical health needs and people living with dementia. At the time of the inspection the agency provided personal care to 157 people and employed 51 care workers.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The previous report recommended improvements needed to be made regarding the assessment and management of risks to people, including the safe moving and handling of people. At this inspection we found risks to people were assessed and arrangements put in place to control these risks. As a result, the rating of Requires Improvement under Safe has improved to Good.

The majority of people said they received care at times they agreed to but there were some exceptions to this. Care plans did not give specific times when care workers should arrive at people’s homes to provide care and three people were critical of the times care was provided. The provider was aware of this and was taking action to reorganise the service and to recruit more care workers.

People said they received safe care from the care workers who had a good awareness of the importance of protecting people. Medicines were safely managed. Checks were made on the suitability of new staff to work in a care setting. Care workers followed procedures to prevent the spread of infection. Reviews of care and incidents took place.

Care workers were supported well and had access to a range of training courses including nationally recognised qualifications in care.

People’s nutritional needs were assessed and people were helped with food and drinks when this was part of their care package. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Care workers treated people with kindness and respect. People were involved in decisions about their care. People’s privacy was promoted.

People’s needs were assessed and care plans reflected people’s preferences and choices.

The service was well – led and was responsive to the challenges it faced. There were strategic plans to develop and enhance its service provision. The provider ensured care workers were supported to develop their skills and knowledge. There was a system of checks and audits regarding the safety and quality of the service provided.

Further information is in the detailed findings below

The inspection took place on 12 February 2016 and was announced.

Guild Care Domiciliary Care provides support and personal care to people in their own homes. It covers the geographical area along the West Sussex coast from Littlehampton up to Southwick. People receiving home care support have a range of needs: physical and/or mental health issues, medical conditions, older people and people living with dementia. At the time of our inspection approximately 183 people received some form of support from the service.

At our last inspection to the service in June 2015, we made two compliance actions. We found the service did not have a robust system in place to assess people’s risks safely, issues relating to obtaining people’s consent and staff understanding of the Mental Capacity Act 2005. We asked the provider to take action and they submitted their action plan outlining what steps would be taken to meet the breach of regulations previously identified. At this inspection, we found sufficient action had been taken and the provider was now meeting the requirements of those regulations.

A registered manager was 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.

Overall, risks to people were managed appropriately. Risks had been identified and assessed and information provided to staff on how to mitigate the risks. The provider planned to introduce training to staff on the drawing up of risks assessments to ensure that risks to people were managed safely and information was relevant and up to date. We have made a recommendation to the provider relating to the review of all risk assessments within people’s care records to ensure these accurately reflected people’s risks. People and their relatives felt they received a safe service. Staff understood what action to take if they suspected people were at risk of abuse and had received training on safeguarding adults.

There were sufficient staff available and overall people felt that staff spent sufficient time with them, although some people stated staff arrived late occasionally. Safe recruitment practices were in place and checks were undertaken on new staff before they commenced employment to ensure they were safe to care for people.

People’s medicines were managed safely and people were assessed in their ability to take their own medicines. There was no audit of medicines in place at the time of our inspection. We were told that an audit was being planned, although there was no evidence available to corroborate this development. People were supported by care staff to have sufficient to eat and drink and had access to a range of healthcare professionals and services. They were supported to express their views and to be involved in the planning of their care. People felt they were treated with dignity and respect by kind and caring staff and that they were encouraged to be as independent as possible. People received personalised care and care plans provided comprehensive information to staff, including people’s personal histories, likes and dislikes. Complaints were managed in line with the provider’s policy and to the satisfaction of the complainants. However, some people felt that they could not always make contact with the office staff.

Staff had received training on the Mental Capacity Act 2005 and understood its requirements relating to gaining people’s consent and making decisions. New staff undertook a comprehensive induction programme, including the standards of the Care Certificate, a universally recognised qualification. Other staff completed training in a range of areas and records confirmed this was up to date in all essential topic areas. Staff receiv

We spoke by phone with 19 people who used the service and one relative. We also sent a questionnaire to 61 people and relatives and had 35 responses. We also spoke with staff, the manager and reviewed records at the Guild Care office.

The majority of people were satisfied with the help and support they received from Guild Care. One person said, "I'm very pleased with everything." Another person said, "I'm very happy with it." People told us that care staff were kind to them and met their needs. People said that their consent and feedback was sought in relation to their care. However, more than half of people raised concerns about late or inconsistent calls and unreliable staff. This meant that people were at risk of inappropriate or unsafe care.

We found that people were cared for by suitably qualified and experienced staff. This was because the organisation had robust recruitment practices which included an application, interview, references and background checks. People told us that staff were professional and suitably skilled.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. The majority of people we spoke with were happy with the way complaints were managed and responded to.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience, who has experience of using or caring for someone who uses this type of service.

We were able to speak on the telephone with fifteen people who received a service from Guild Care Domiciliary Care. Overall, people we spoke to on the telephone were happy with the service, although occasionally a person told us of issues with the timing or length of visits.

We also visited three people at home to ask them for their views about the standard of care they received. The three people we visited at home told us they were happy with the service, that the carers were reliable, and that staff were friendly and treated them with respect. Comments they made to us about the service included “staff support me to be independent and do things the way I’d wish”, and “they are good at sorting things out if there’s a problem”.

The inspection took place on 15 and 16 June 2015 and was announced.

Guild Care Domiciliary Care provides support and personal care to people in their own homes. It covers the geographical area along the West Sussex coast from Littlehampton up to Southwick. People receiving home care support have a range of needs: physical and/or mental health issues, medical conditions, older people and people living with dementia.

The service has 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.

People’s safety was compromised in some areas. Risks to people were not managed safely. People’s risks had not been assessed adequately to keep them from harm. There was conflicting information in people’s care records as to whether they needed prompting to take their medicines, needed medicines to be administered or could take their medicines independently. People’s medicines were not managed safely. People said they felt safe and staff knew what action to take if they suspected people were at risk of abuse. Staff had received training in safeguarding adults at risk. There were sufficient staff to meet people’s needs safely and the service followed safe recruitment practices.

Staff understanding of the Mental Capacity Act (MCA) 2005 and the requirements of this legislation was patchy. People’s capacity to make decisions had not been assessed or documented in their care records. Apart from a lack of dedicated training to staff on the MCA, staff had received all essential training. People spoke positively about the care and support they received. The provider had a comprehensive induction programme. Staff had regular supervisions and appraisals, however, some staff supervisions and appraisals were not up to date. The registered manager was taking steps to improve this. People generally had sufficient to eat and drink, but food and fluid monitoring charts did not always show the quantities that people had consumed on a daily basis. This put people at risk of malnourishment. People were supported by staff to have access to healthcare professionals when needed.

People spoke highly of the staff who supported them. Positive, caring relationships had been developed and people were treated with dignity and respect. People were encouraged to express their views and to be involved in decisions about their care.

The provider had made improvements to the punctuality of staff and call times to people’s homes were monitored and audited. Care plans provided information to staff about people’s likes, dislikes and preferences. Daily records were completed by staff and kept on people’s home care files. Concerns and complaints were responded to and acted upon in a timely fashion, in line with the provider’s policy.

People had mixed views about the service; some comments were positive, others not so positive. People were asked what they thought about the quality of the service through a ‘home care survey’ which was last completed in July 2014. Staff were not formally asked for their views about the service. The provider undertook comprehensive audits, however, they had not identified that risk assessments were unsatisfactory. The audit had identified that there were gaps in Medication Administration Record (MAR) sheets and that, in some cases, staff supervisions and appraisals were overdue.

We found two of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.