Our inspection took place on 19 September 2016 and was announced. At our last inspection on 22 January 2014 we found the provider was meeting all the standards we looked at.

JS Parker is a brain injury case management, rehabilitation and support service that provides support and care to people of all ages living in their own homes. At the time of our inspection there were 47 people using the service.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Everyone we spoke with told us they or their relative were very safe using the service. Risks associated with support and care were assessed, and the provider documented this in a person centred way which ensured staff understood how to minimise risks in ways the person preferred. The provider had a proactive approach to positive risk taking, meaning people were able to follow their preferred lifestyles safely.

Staff recruitment was carried out safely and was bespoke to each support package, and people who used the service and their relatives spoke positively about their involvement in the processes. They were able to spend time with candidates and ask them questions, and said they gave feedback which helped the provider make recruitment decisions.

Staff received a thorough induction and the provider had a rolling programme of training in place to ensure staff remained effective in their roles. In addition staff told us they had regular supervision meetings and an annual appraisal, and felt they had adequate contact with managers to discuss their performance and ask for and additional training they felt they needed.

Staff understood the principles involved in safeguarding people and the different forms potential abuse can take and when and how to report their concerns. Staff said they were confident the registered manager would act on information reported to them, and understood they could also report concerns to external bodies such as the CQC.

People’s medicines were managed safely. Staff received regular training in the administration of medicines and case managers regularly observed their practice. Records relating to the administration of medicines were completed correctly.

Consent was gained appropriately for all support and care from people who used the service. People’s capacity to make particular decisions was recorded, and there were appropriate processes in place to ensure people received help to make decisions they could not make for themselves.

People who used the service were supported to have access to healthcare professionals, and we were told staff worked well with these teams to further their understanding of people’s needs.

We found people who used the service had good relationships with their support workers. Staff had access to information about people’s likes, dislikes and preferences in the support plans, and we saw evidence of people’s involvement in writing these.

The provider had a robust approach to embedding principles of privacy and dignity in staff practice, and we received good feedback about this approach from people who used the service and their families.

Support plans were based on a pre-assessment by the provider to ensure they could meet people’s needs before they started to use the service. This assessment was used to devise a series of individual activity plans which showed how support should be provided. We saw people were involved in regular reviews of the support plans to ensure they always reflected people’s up to date needs.

The provider had systems in place to ensure complaints were recorded and investigated appropriately. People told us they received information about how to make a complaint whe

We spoke with two people receiving support and three relatives about their experience of the care and support they or their relatives had been provided with. All were extremely positive about the support they received. One person receiving care told us: “They are very good, everybody stays in touch and they discussed what I needed. The occupational therapist sorted for me to have a bathroom downstairs to help me stay as mobile as possible.”

Comments from relatives we spoke with included; “The team are really helpful, the care and quality is good. They do what X likes” and “We have good continuity of support workers; we are involved in the interview process. We had one person which didn’t work out, but everything is fine now, staff interact well with X.”

We looked at three support plans and noted consent forms had been signed by individuals or their relatives.

We looked at three peoples support plans, all included assessments of need, care plans and risk assessments. These provided staff with the outcomes people wished to achieve from their care. We saw records of peoples’ likes and dislikes and personal preferences.

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in cooperation with others.

People’s personal records and staff records were accurate and fit for purpose.

People who used the service said the staff were polite and they were fully involved in making any decisions about their care. They said they were very happy with the service provided and they had no complaints to make. Their comments included:

“The staff are always very polite.”

“The staff are fully aware of my care needs, everything is ok and I am very happy.”

“The carers are fantastic, I always get the care and support I need. My care package was reviewed just before Christmas and I was fully involved in the meeting. My case manager is great. She is very efficient.”

“The management is very good and I have no complaints to make.”

Relatives of the people who used the service said they were very happy with the service provided. They said they received good support from their case manager and felt the agency was well managed. Their comments included:

“The staff are great, they are all very friendly and professional.”

“I’m really happy with the support my relative receives. His support worker is fully aware of his care needs. His case manager is brilliant. She just gets things done.”

“My husband’s case manager is excellent, I don’t know where I would be without her. She is proactive, organised and very professional. His support worker is lovely, very respectful and helpful, my husband likes him a lot.”

“Everything has always worked very well. Lorna the manager is very good, I have absolutely no problems at all.”