We carried out this announced inspection by visiting the office on 30 March 2016. Following this, we spoke with people who used the service, relatives and members of staff by telephone. At the time of the inspection, the service provided care and support for 73 older people living in their own homes.

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.

People using the service were kept safe from any risk of harm and staff knew how to report any concerns regarding people’s welfare. Risk assessments were carried out on both the environment and on behalf of the person to detail ways in which they could be kept safe. There were enough trained and competent staff available to meet people’s needs, and people told us they usually received their calls on time. There were robust recruitment procedures in place to ensure that staff employed were suitable to work in the service. People received their medicines as prescribed by staff who were trained and competent.

Staff received a variety of training that was regularly updated and refreshed as required. Supervisions and performance reviews took place with the management team to provide them with an opportunity to develop their skills further. Training was provided to understand the Mental Capacity Act 2005 and assessments were carried out where people required decisions to be made on their behalf. People consented to their care and support. People’s healthcare needs were met by the service and they were referred to other healthcare agencies for support where required. People who required support with cooking, eating and drinking had their dietary needs met.

Staff were caring and understood the people they were providing care to. People were treated with dignity and respect and given opportunities to give their feedback on the quality of their care.

People’s care plans were detailed and comprehensive enough to provide an overview of the person’s needs and preferences. If people’s needs changed then the service were responsive to this and worked closely with other stakeholders to ensure consistency of care. Regular reviews took place with the person and their relatives to give them an opportunity to contribute to the planning of their care. The service had a robust policy in place to handle complaints and dealt promptly with those received.

People, relatives and staff were positive about the management of the service. The visions and values of the provider were clear and people spoke highly of the ethos of the organisation and how it translated into practice. Staff were given opportunities to develop and contribute to the service through team meetings. There was a robust system in place for quality monitoring and identifying improvements that could be made in all areas of the service.

We spoke with two people and two relatives of people using the service. They told us they were happy with the care and support they received from staff. People told us that, prior to them receiving care, staff had visited them and provided them with information about the service and asked about their support and care needs.

Care plans were detailed and contained good guidance for staff. Two relatives we spoke with said that the staff understood their relative's needs, and knew how to care for them. One relative said ,” The staff know my relative's likes and dislikes. They have built up a good relationship with her.”

All of the people we spoke with said that the care staff generally arrived within 15 minutes of the expected time and had never missed a visit. People felt their views were listened to and felt confident to make a complaint if they needed to.

During our review we visited three people who received a service from this agency on 26 January 2012. In addition, we spoke on the telephone to a further person and two relatives of people who receive a service on 03 February 2012. They all spoke very positively about the care and support they received from this agency.

People told us that, prior to them receiving care, agency staff had visited and provided them with information about the service and asked them about their support and care needs.

They told us that staff understood their or their relative’s needs, and knew how to care for them. They all said staff treated them and their homes with respect. One person told us, “I don’t like having anyone in but if I must then they are very good and treat me well.”

A relative told us that the service was flexible and that they had, at short notice, increased the care provided to their relative when they requested this.

All of the people we spoke with said that the care staff generally arrived within 15 minutes of the expected time and had never missed a visit.

Everyone we spoke with told us that they felt safe with, and trust, the staff that supported them. They all said they were confident that the manager would listen to, and address, any issues of concern they raised.

We spoke with 15 people who used the service, six staff and the registered manager. People said that they were happy with the care provided and that staff respected their privacy and dignity. One person said, “Staff cover me with a towel when providing personal care and close doors and curtains.”

We found that people’s needs had been assessed to ensure the care they received was safe and effective.

The agency had procedures in place to ensure that people were safeguarded against the risk of abuse and staff had been provided with appropriate training. One person said, “Staff saw bruising on my arms and asked how it had happened. They are always mindful of unexplained marks or injuries.” This demonstrated that staff acted appropriately if they suspected people were at risk of harm.

We found that the agency had effective recruitment procedures to ensure appropriate checks were undertaken before staff commenced work.

We found that although there was a system in place to provide staff with supervision and appraisal this was not consistently delivered to all staff in line with the organisation’s procedure.

The agency had a system in place to assess and monitor the care provided to people. This ensured people were listened to, acted on and addressed in a timely manner.