Mears Care St Neots provides personal for people living in their own homes.

Our last inspection took place on 25 November 2013 when we found the provider was meeting all the regulations we looked at.

This unannounced inspection took place on 2, 3, 8 and 10 June 2016. There were 128 people receiving care at that time in Cambridgeshire.

The service had 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.

Systems were in place to ensure people’s safety was effectively managed. Staff were aware of the procedures for reporting concerns and of how to protect people from harm.

Staff were only employed after the provider had carried out comprehensive and satisfactory pre-employment checks. People experienced a good quality of life because staff were well trained which gave them the skills and knowledge to meet people’s assessed needs. Staff were well supported by their managers. There were enough staff to meet people’s assessed needs.

People received their prescribed medicines appropriately. People’s health, care and nutritional needs were effectively met.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that there were formal systems in place to assess people’s capacity for decision making and applications had been made to the authorising agencies for people who needed these safeguards. Staff respected people choices and staff were aware of the key legal requirements of the MCA and DoLS. People’s rights to make decisions about their care were respected. Where people did not have the mental capacity to make decisions, they had been supported in the decision making process.

People received care and support from staff who were passionate about providing good quality care. They were kind, caring, respectful and friendly. There was a strong emphasis on person centred care. Staff actively encouraged and promoted people’s independence. They were proactive and looked for innovative ways of delivering people’s care that focused on enabling people to maintain their independence.

Staff showed consideration of people’s views. People and their relatives had ample opportunities and were encouraged to comment on the service provided. Staff involved people, and those important to them, in planning and delivering the service, ensuring the service provided was based on each person’s needs and wishes. People were fully involved in every day decisions about their care.

Care records were detailed and provided staff with sufficient guidance to provide consistent and individualised care to each person. Changes to people’s care were kept under review to ensure the change was effective. There were opportunities for people to pursue their interests and maintain community links.

The experienced registered manager was supported by a highly motivated staff team. The service was very well run and staff including the registered manager were approachable and supportive. Staff understood fully what was expected of them. They understood and worked to the provider’s values, always placing people at the centre of the service.

The service had a positive culture of continuous improvement. People and their relatives were encouraged to provide frequent feedback on the service both formally and informally. People’s views were listened to and acted on. Concerns were thoroughly investigated plans actions were taken to bring about improvement in the service. The service had an effective quality assurance system. Where improvements were needed, these were addressed and followed up to ensure continuous

We spoke with six people who received a service from the agency, and with two relatives. They all spoke very highly of the service that they or their relative received. People said that staff understood their care and support needs and were polite and helpful. One person we spoke with told us the service they received was: “Excellent”. Another person told us: "Staff are always respectful".

Staff we spoke with were knowledgeable about people's care and support needs and we observed staff speaking with people in an attentive and polite way.

Care plans we looked at were person centred and provided staff with guidance about how to meet people’s care and support needs. Regular reviews were undertaken and care plans were updated when there were any changes to people’s needs.

Appropriate recruitment procedures were in place to ensure that the necessary checks were carried out prior to staff starting work. Staff told us that they received good training and support that enabled them to carry out their roles effectively. Staffs’ competency to do their job was checked regularly as part of a quality assurance system.

There were systems in place to seek people’s feedback about the quality of the service they received. People we spoke with told us that they felt confident that they could raise any concerns they had with the agency and that action would be taken to address these.

We spoke with three relative's of people who received a service from the agency. They all spoke highly of the service that their relative received. They said that the staff were always on time, were kind and capable of meeting their relatives needs. One person said, "They go beyond the call of duty". Another told us, "They are always prompt, I cannot praise them enough".

Thorough assessments of people's needs were carried out prior to them receiving a service from the agency. The assessment formed the basis of the care plan which provided clear guidance to staff about how to meet people's needs. Regular reviews were held to ensure that the care plans were updated when there were any changes to people's needs. There was an appropriate complaints procedure in place which people were informed about.

Appropriate recruitment procedures were in place to ensure that the necessary checks were carried out on staff prior to them starting work. Staff told us that they received good training and support that enabled them to carry out their roles effectively.

The purpose of this review was to assess improvements made in relation to shortfalls identified during our previous review of compliance undertaken on 14 January 2011; we did not request information directly from people using the service. At the previous review in January 2011, people advised us that the care provided to them or their family members was good and very helpful when organising care when they wanted to go away. People said they had the necessary contact details for the office (including out of hours) and weekly information on which staff member would be providing their care.

We have received no complaints about this service.

All the people we spoke with said that the care provided to them or their family member was good with comments such as, "brilliant", "much appreciated", "couldn't be better" and "couldn't do without them". One person said the agency "seemed more efficient" since they had been taken over.

One person said the agency had been very helpful in organising care when they wanted to go away.

Everyone we spoke with had the contact details for the office (including out of hours) and weekly information on which staff member would be providing their care.

We have received no complaints about this service. People were satisfied with the care they received and were clear about who to speak to if issues were to occur.