What life is like for people using this service:

Everyone we spoke with was happy with the care agency and the staff that provided their care. They all told us it was the best agency they had used and that staff were reliable. One person told us, “[Staff] deal with situations and don’t leave. When they are here they are superb.” Another person said, “They’re excellent, very good. I’m very pleased with them.”

People felt safe using the agency because staff knew what they were doing, they had been trained and visited people to learn how to care for them before having to do so. One person said, “Of course, they know exactly what they’re doing, they’re very good.” There were enough staff, and the registered manager filled in for staff sometimes, who visited people regularly.

People told us they always received their medicines and that staff knew how these should be given. Staff supported people with meals and drinks and did this in a hygienic way, using protective equipment, such as gloves and aprons. They followed advice from health care professionals and made sure they asked people’s consent before caring for them.

People and their relatives thought a lot of the staff that cared for them. One person told us, “I like the care staff,” and went on to say, “What makes the difference is they’re so friendly.” Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected. Staff worked well together, they understood the agency’s aim to deliver high quality care, which helped people to continue to live in their own homes.

However, we found that there was some documentation that had not been completed, updated or looked at and despite staff knowing how to care for people, this put people at risk. Systems to monitor how well the agency was operating were not carried out well enough. This meant that where records were not detailed enough or were not available, this had not been found. Key recruitment checks were not always obtained before new staff started work. Where concerns were identified, the registered manager did not follow this up to make sure the staff member was suitable to work in this role. Medicine records were not always completed accurately or with enough detail.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There was a registered manager in post at the time of this inspection.

In two areas we found that shortfalls in documentation did not meet the characteristics of Good and we have rated these areas as Requires Improvement. This is the first time the service has been rated Requires Improvement. You can see what action we told the provider to take at the back of the full version of the report.

Rating at last inspection: Good (last report published 11 June 2016)

About the service: Ness M Care Services is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to younger and older people aged over 18 and over.

Why we inspected: This was a planned inspection based on our previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as scheduled in our re-inspection programme. If any concerning information is received we may inspect sooner.

Ness M Care Services is registered to provide personal care for people who live at home. Both domiciliary care and live-in care is provided to people who live in a number of counties, including Lincolnshire, Cambridgeshire, Buckinghamshire, Nottinghamshire and Norfolk. When we visited there were 14 people who were receiving support and care from the agency.

The inspection took place on 24 May 2016 and was announced and carried out by one inspector.

A registered manager was in post when we inspected and had been registered since 13 September 2013. 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.

People were kept as safe as possible because staff were knowledgeable about reporting any person being placed at the risk of harm. There was a sufficient number of staff employed and recruitment procedures ensured that only suitable staff were employed. Arrangements were in place to ensure that people were protected with the safe management of their medicines.

The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA] and the Deprivation of Liberty Safeguards [DoLS] and to report on what we find. The provider was acting in accordance with the requirements of the MCA so that people had their rights protected by the law. Assessments were in place to determine if people had the capacity to make decisions in relation to their care. When people were assessed to lack capacity, their care was provided in their best interests. The provider was aware of the procedures to follow should any person require A DoLS application made to the Court of Protection.

Staff were trained and supported to do their job so that people received care that safely met their needs.

People were supported to access a range of health care professionals. Health risk assessments were in place to ensure that people were supported to maintain their health. People were provided with adequate amounts of food and drink to meet their individual likes and nutritional and hydration needs.

People’s independence, privacy and dignity were respected. People were supported to maintain contact with their relatives.

People’s recreational and social activities that people enjoyed were identified and they were supported to take part in these. People’s care records and risk assessments were kept up-to-date and which meant that staff had the guidance in how to meet people’s individual needs. A complaints procedure was in place and this was followed by staff this meant that people could be confident that any complaints would be dealt with appropriately.

The provider had quality assurance processes and procedures in place to improve the quality and safety of people’s support and care.

People's care plans we reviewed included arrangements where a family representative signed to agree to the person's care. Staff training and knowledge of the Mental Capacity Act 2005 and providing care to people living with dementia meant that care would only be provided where consent to this had been obtained.

Care plans and records we looked at were comprehensive and detailed and demonstrated to us that the information and guidance would allow any member of staff provide each person's care. People were supported to maintain or improve thier independence as far as reasonably practicable. We saw that regular reviews of people's care had been completed by the provider. People were supported to be seen by healthcare professionals including by their GP.

Records of staff recruitment we viewed evidenced to us that staff were only employed at the service after they had been safely and adequately assessed as being safe to do so. Disclosure and Barring Service (DBS) checks had been completed before staff commenced their employment working with vulnerable adults.

We saw that the provider sought the views of staff, healthcare professionals and family representatives on the quality of care provided. We saw that comments from people who used the service and their relatives were all positive about the care they had been provided with.