What life is like for people using this service:

People were supported by a consistent group of staff who were aware of the risks to them and how to keep them safe from harm. Where safeguarding concerns had been raised, they had been responded to and acted on appropriately. Individual lessons where learnt when accidents and incidents took place, but overall analysis of this information was inconsistent.

Staff felt well trained and supported in their role. People were happy with the care they received and felt it met their needs. Staff practice was regularly observed to ensure people were supported safely and effectively and in line with their care needs. Staff had received training in relation to the Mental Capacity Act and were mindful of the need to obtain people’s consent prior to supporting them. People were supported, where appropriate at mealtimes.

People were treated with dignity and respect by staff who were kind and caring to them. People were encouraged to maintain their independence and were supported to be involved in decisions regarding their care.

Staff were aware of people’s needs and individual preferences. People were involved in the planning and review of their care. People were confident that if they raised a concern, it would be dealt with appropriately. Where complaints had been raised, they had been responded to and acted on appropriately.

People and staff were complimentary of the service and considered it to be well led. People were asked for feedback on their experience of the service through surveys and telephone calls. Staff felt supported and listened to and able to contribute to the running of the service. A number of quality audits were in place and the provider and the registered manager had plans in place to drive improvement in the service.

Rating at last inspection: The rating of the last inspection was ‘Good’. This report was published on 17 May 2016.

About the service: This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to both younger and older adults. At the time of the inspection they were providing personal care and support for up to 260 people.

Why we inspected: This was a planned inspection.

Follow up: We will monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

This inspection took place on 2 March 2016 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service. This was because we wanted to make sure staff would be available to answer any questions we had or provide information that we needed.

At our last inspection in October 2013 the provider was meeting all of the regulations that were assessed.

The service is registered to provide personal care and support to people in their own homes and at a supported living service. People who use the service had a range of support needs related to old age, dementia, mental health, learning disability or an eating disorder. At the time of the inspection the service was providing support and personal care to 180 people in their own homes and 19 people in a supported living unit. Supported living enables people who need personal or social support to live in their own home supported by care staff instead of living in a care home or with family. The levels of support people received from the service varied, according to their assessed needs and levels of independence.

There was a manager in post who had planned to become registered manager of the service.

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 were supported by staff who had received training in how to recognise possible signs of abuse and how to report any concerns. Staff were aware of their responsibilities in this area and what actions they should take.

Recruitment processes had recently been improved to ensure that people were supported by suitable staff. Staff received induction training which included shadowing colleagues prior to working on their own. Training was in place in order to develop staff skills and staff were able to ask for additional training to develop their levels of expertise in particular areas.

Staff had not received formal supervision and had not been given the opportunity to discuss their learning or receive feedback from observations of their practice, but arrangements were in place to rectify this.

Staff were aware of the risks to the people they supported, but information held on risk assessments lacked detail which meant staff were not always provided with the most accurate information to enable them to manage risks.

People were supported to live their lives in the least restrictive way possible; staff understood the

requirements of the Mental Capacity Act [MCA], and what it meant for the people they supported.

People were supported with their nutrition and health care needs.

People told us that the staff who supported them were kind and caring and treated them with dignity and respect.

People were supported by staff who were aware of their likes and dislikes and how they liked their care to be provided.

People knew how to raise concerns and complaints; where complaints had been raised they were logged and recorded but they were not always investigated or responded to. Improvements in the complaints systems had been put in place to ensure people felt confident that their voice was heard and any lessons were learnt, where appropriate.

The manager had identified a number of areas for improvement and was working closely with the provider and staff to achieve these improvements in order to improve service delivery.

The manager was described as supportive and approachable by the staff group and her leadership skills were spoken of in a positive manner.

Quality monitoring of the service had taken place in response to particular concerns but not on a regular basis. Plans were in place to address this and obtain regular feedback from service users.

The service is currently supporting 81 people. We carried out telephone interviews with eight people who use the service and three relatives. We spoke with the manager, care coordinator and three carers.

People who used the service were happy with the support provided and described carers as ‘very kind’ ‘very punctual’ and ‘respectful and approachable. One person said, "They are really good and quite flexible”.

We saw that people's needs were assessed and support plans were developed in consultation with them as confirmed by people we spoke with. Carers were well informed about people's needs, health conditions and how to manage risks to their welfare.

People had support to manage their medicines and carers were trained in how to do this safely.

Appropriate checks were undertaken to ensure all staff were suitable to work with people in their own homes.

People's personal information was stored safely and remained confidential.

We spoke by telephone with seven people that used the agency. We also spoke with the owner, manager, care coordinator and four care workers.

People are consulted about their support needs and the care plans we saw matched what they told us. One person said, “I’m really happy with the agency the carers are decent people and understand my needs”.

People told us they knew how to report any concerns they had about their own safety. We saw carers had training to assist them in protecting people from harm.

People told us there were enough carers to see to their needs. We saw carers had the training they needed to meet the needs of the people they supported.

Care workers told us they are supported by the manager, and had an induction and training to help them do their jobs well.

There is a system in place to identify and manage risks to the health or safety of people using the service.

People know how to make a complaint if they are not happy with the agency. One person said, “I’ve not had to complain I’m really happy with my carers, always on time and don’t rush me”.