This inspection took place on the 10 and 13 February 2017 and was announced. During our last inspection in November 2015 we rated the service as ‘good’.

Medow Care Services Limited is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 45 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 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 risk of harm and staff understood the ways in which they could be safeguarded from abuse.

Risk assessments were detailed enough to minimise any risk to each person and to account for risks of working in people’s homes.

Care plans contained sufficient information to ensure that people’s needs were being met where necessary, including their dietary and healthcare needs.

Satisfaction surveys were sent out to ensure that people were happy with the care they received, and improvements were made on the basis of people’s feedback.

Staff received the correct training to undertake their duties effectively, and received supervisions and performance reviews to support their continued development.

Staff understood their roles and responsibilities and were knowledgeable about the ways in which people gave consent and how the Mental Capacity Act was applied in practice.

Staff demonstrated a caring attitude and understood how to treat people with dignity and respect.

Staff meetings were held regularly and provided an opportunity for the team to meet and discuss issues affecting the service.

New staff received a full induction into the service, and robust recruitment procedures were in place to ensure they had the skills and experience necessary for the role.

Where people required support with administration of their medicines, the service kept appropriate records and information on their file.

Quality audits were completed regularly to ensure that the service was identifying any areas for improvement and taking appropriate action to resolve them.

People and staff were positive about the registered manager and management team within the service and shared their visions and values.

People knew who to complain to if necessary, and the manager had an effective system in place for handling and resolving complaints.

We carried out this announced inspection by visiting the office on 4 September 2015. Between this date and 10 September 2015, we spoke with people who used the service or their relatives and staff by phone.

The service provides personal care and support to adults in their own homes. People supported by the service were living with a variety of needs including older people with health conditions, physical disabilities and dementia. At the time of the inspection, there were 48 people who used the service.

The service has a registered manager. 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.

There were systems in place to safeguard people from the possible risk of harm. There were risk assessments in place which provided guidance to staff on how risks to people should be managed and minimised.

The provider had effective recruitment processes in place to ensure that staff employed to work for the service were suitable for their roles. There were sufficient numbers of staff to support people safely.

Staff were skilled and knowledgeable in how to support people in accordance with their agreed care plans. Staff received regular supervision and support, and had been trained to meet people’s individual needs.

Staff were aware of their responsibilities and understood their roles to seek people’s consent prior to care being provided. People received care and support from a team of caring and respectful staff.

People’s needs had been assessed, and care plans included their individual needs, preferences, and choices. The provider had a formal process for handling complaints and concerns.

There were effective quality monitoring processes in place. Regular checks and audits had been carried out and people’s views had been sought regarding the quality of the service.

The people we spoke with were complimentary about the service they received, the staff and the management. One person said " The care staff is extremely reliable and is always friendly and cheerful." Another person said "Best care I ever had. The carers arrive on time. They are brilliant. They record everyday what they had done in the care plan." One relative said "I can not fault the care my mother is receiving. The carers are obviously well trained."

We found that the provider was meeting the standards we had inspected. People and their relatives had been consented to their care and support they needed. People's received care and support in line with their agreed care plans. There was a recruitment procedure in place and all the required checks had been carried before an offer of employment had been made. There was a quality assurance system to assess and manage the quality of service. Records and confidential files had been kept safely and securely in the office.

We spoke with eight people who use the service and some of their relatives via the telephone. They said that they were happy with the care and support they received from the staff. One relative we spoke with felt that the staff were helpful and another said that they were happy with the service they received. However, one relative expressed some concerns about the support provided.

We found that people’s privacy and dignity had been respected and they and their relatives had been involved in the decisions about their care package. The care plans we reviewed provided up to date information about the needs of each person, and showed how the staff had been supporting people in meeting their needs.

There were systems in place to ensure that any allegations of abuse would be reported to the appropriate authorities. This ensured that people were protected from the risk of abuse.

Staff had been supported and provided with the relevant training so that they were competent in their role and were able to meet people’s needs appropriately.

There were systems in place to assess and monitor the quality of the service. Questionnaire surveys had been carried out in seeking the views of people and their relatives and the feedback from these questionnaires was positive.