About the service: The service supports people with personal care needs in their own home. Some people were also supported whilst their main family carer took a break from their caring role. Others were supported to access the community to reduce the likelihood of social isolation. The service supported 63 people when we inspected.

What life is like for people using this service:

Lots of checks were completed by staff, the registered manager and provider to check the quality and safety of the service. The provider had reflected on their approach and planned to make changes to how they recorded checks of the service. This included a review of the accident and incident system, medicines system and risk assessment of people’s care needs.

Overall, people received care in a timely way from a regular team of care workers. However, people felt they needed better communication from the office to know who would be visiting their home and when staff would be delayed. The registered manager agreed to look at how improvements could be made to communication.

Everyone we spoke with told us that staff were kind and caring and that they were treated with respect. Staff showed a genuine motivation to deliver care in a person-centred way based on people’s preferences and likes. People were observed to have good relationships with the staff team.

People’s health was well managed and staff had positive links with professionals which promoted wellbeing for them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff had received appropriate training and support to enable them to carry out their role.

The registered manager and senior team worked well to lead the staff team in their roles and ensure people received a good service. People, their relatives and staff told us they were approachable and that they listened to them when they had any concerns or ideas. All feedback was used to make continuous improvements to the service.

More information is in Detailed Findings section below.

Rating at last inspection: Good (report published 14 January 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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

We spoke with three people who received a service and four people’s relatives to help us understand how the service was provided. In addition we spoke with five carers, the area manager and the care-co-ordinator, who all explained how the service operated.

The people we spoke with and their relatives were very complimentary about the care they received. They told us they were more than happy as their needs were currently met. One person commented: “We couldn’t manage without them.” Another said

"They do everything I ask of them."

People told us they felt safe when carers were looking after them. One person said “They wear a uniform and have an ID badge; I know them anyway but the uniform and ID badge do give you extra confidence, when they are in my home.”

People told us they had a rota, so they knew who was coming to them. All of the people we spoke with could not remember ever having a time when the carer did not turn up when expected. They thought there were enough people to deliver the care needed.

The staff we spoke with told us they had received induction training and further mandatory updates which included moving and handling and safe administration of medicines.This meant people could be assured the staff were kept up to date with the knowledge and skills they needed to deliver care and support safely.

The provider had an effective system in place to regularly assess and monitor the quality of service that people received.

The people who used the service told us that they had given their consent to receive a service from the agency. One person said “The agency staff spoke with me about the service they could provide”. Another person said “I signed to say I agreed with the help that was going to be provided for me”.

We were told by people receiving care and support that they received the help and support they needed from the agency staff. One person said “I receive the care I need from the staff”. A representative of a person receiving a service said “There is a care plan in our home. Staff record what they do for my relative on each visit”.

People we spoke with told us that they felt comfortable to raise any issues with the agency and felt issues raised would be looked into. One person said “I would ring the agency and speak with them about any issues straight away”.

The people who used the service said they felt there were enough staff employed by the agency with the right skills to meet their needs. One person said “The care I receive is absolutely fine I have the same care staff so continuity of care is provided. At weekends it can be any of the team who I know”.

People told us that their views about the service they were receiving were asked for. One person said “The area manager has been out a few times to check my service. The support I have received has been fine for me”. Another person said “The quality of the service is regularly checked”.

The last inspection took place on 12 November 2013 and the service was meeting the regulations we assessed.

This inspection took place on 30 October 2015. We visited the office and gave the service 48 hours’ notice. We contacted people by telephone to gather their views and these calls took place on 20 and 23 November 2015.

The service provides personal care and support to people in their own home. The service predominantly supports older people. However they do provide some support to younger people with physical and/or learning difficulties. At the time of our inspection the service provided personal care and support to 121 people and employed 48 care staff. The service has a contract with North Yorkshire County Council.

The service had a manager registered with the CQC. 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.

Overall people told us they felt safe and feedback about the care provided was positive. However, some people expressed concern about the consistency of their care team. This was echoed by some of the care staff we spoke with, and they also raised concerns about not always having enough time between care calls.

The service was continually recruiting new staff and was continuing to expand in terms of the amount of support they provided and the number of staff they employed. There was an effective recruitment and selection policy in place which meant staff were recruited safely.

The service offered effective training and support to new staff to ensure they provided a good standard of care. Following this there was ongoing training based on the individual needs of staff. Staff told us they were well supported and we saw there was access to regular supervision meetings with their manager.

The management team and staff we spoke with demonstrated an understanding of the principles of the Mental Capacity Act (2005) and explained they sought consent from people before they provided care and support.

People told us care staff were kind and caring and they felt well supported. Staff spoke with enthusiasm about their roles and were keen to support people to receive good care. Despite the fact that some staff were concerned about, consistency of care and travelling time between care calls, all of the staff we spoke with said they would be happy for their relative to receive support from the service, if they needed this type of care.

Care plans contained relevant information to enable care staff to provide the support people required, however, the care plans we reviewed were focused on tasks to complete. Staff might be able to deliver more personalised care, particularly for people living with dementia, if they were more person centred. Despite this people told us they were happy with their care and had regular reviews. Where necessary we saw the service accessed support from health and social care professionals. Care plans contained risk assessments and people were protected from avoidable harm.

People were provided with information about how to make a complaint.

The registered manager demonstrated a good awareness of the strengths of the service and areas where further development was required. Staff told us they were well supported and the service had effective systems in place to review the quality of care they delivered.