We carried out this announced inspection on the 21 and 25 May 2018.The provider was given 24 hours’ notice because the location provides a domiciliary care service; we needed to be sure that staff would be available to talk with us.

This service is a domiciliary care agency. New Forest Home Care provides personal care and support to people in their own homes. At the time of our inspection the agency was providing a service for 27 older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

The service had 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.

We received positive feedback from people about the service. All the people who used the service expressed great satisfaction and spoke highly of the care staff.

People felt safe with the service provided by New Forest Home Care. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. Improvements had been made to recruitment practices to ensure people were kept safe.

The risks to people were minimized through risk assessments, which provided staff with clear guidelines to follow. There were plans in place for foreseeable emergencies.

People were supported to take their medicines safely from suitably trained staff. Staff contacted healthcare professionals promptly when they had concerns about people’s health and wellbeing.

People felt they were treated with kindness and compassion and said their privacy and dignity was respected. Staff had an understanding of the Mental Capacity Act (MCA) and understood that people had the right to make their own choices.

Staff received regular support and one to one sessions or supervision to discuss areas of development. They completed a wide range of training and felt it supported them in their job role.

New staff completed an induction before being permitted to work unsupervised. There were sufficient numbers of staff to maintain the schedule of care visits to meet people’s needs.

Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were supported with their nutritional needs when required. staff were aware of people’s likes and dislikes.

People felt listened to and a complaints procedure was in place and people knew how to make a complaint if they needed to.

Staff felt supported by the management and felt they could visit the office and be listened to. Regular audits of the service were carried out to assess and monitor the quality of the service.

This inspection took place on 4 and 5 April 2016 and was announced.

New Forest Homecare Limited is a domiciliary care service providing a range of services including personal care for people in their own homes. There were 52 people using the service at the time of the inspection. The service provided support to older people some of who were living with dementia. They also supported people with physical and learning disabilities.

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 told us they felt safe and were confident in the staff that supported them. People were safe because staff understood their role and responsibilities to keep them safe from harm.

Staff had a good knowledge of the provider’s whistleblowing policy and procedures which meant they were able to raise concerns to protect people from unsafe care.

Risks to people had been assessed and reviewed regularly to ensure people’s individual needs were being met safely.

Recruitment processes were robust to make sure people were cared for by suitable staff. There were sufficient numbers of staff deployed to meet people’s needs and to keep them safe from harm.

People were supported by staff who received regular training and support to help them provide effective care.

Staff understood the requirements of the Mental Capacity Act 2005 and their responsibilities to ensure that people who were unable to make their own decisions about their care and support were protected.

People were supported by staff that promoted their independence, respected their dignity and maintained their privacy.

People told us they were confident to raise any issues about their care and that they would be listened to and addressed.

People told us the service was well-led and managed by an effective and organised management team. People had confidence in the provider and staff were clear about their roles and responsibilities.

Staff were supported, felt valued and were listened to by the management team.

Staff were confident to raise any concerns they had and bring forward ideas that could make improvements to the service.

Systems were in place to monitor and improve the quality of the service provided.

At the time of our inspection New Forest Homecare Limited was providing approximately 550 hours a week of care and support to 45 people in their own homes.

Our inspection took place over two days. On the first day we visited the agency’s office. We looked at documentation such as care plans, visit schedules, policies and procedures, training records, staff records, surveys and audit material. We spoke with the registered manager and care manager. We also visited and spoke with four people using the service in their home and one relative of a person using the service.

On the second day we spoke with three people using the service in telephone interviews and two relatives of people using the service. As part of our inspection we also spoke with three care workers. This is a summary of what we found -

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

This is a summary of what we found –

Is the service safe?

The service was safe. We looked at daily notes kept in people’s homes and recorded by care workers for each visit they made to a person. The notes showed people had received help and assistance in accordance with their agreed care plans.

We discussed the care notes with three people using the service during our visit. All three people confirmed the notes were an accurate account of the care that had been delivered.

All staff had completed application forms which required them to provide details of previous employment history and declare whether they had a criminal record. Their records showed they had attended formal interviews following the receipt by the agency of satisfactory and appropriate references and their suitability to undertake their roles had been assessed.

We asked two care workers to tell us about the information contained in two people's care plans. Both care workers demonstrated a good understanding of those people’s individual needs. We found the documents to be an accurate reflection of the care and support people needed.

Copies of care plans and staff personnel files were stored securely in separate lockable filing cabinets in the office. Records were kept securely and could be located promptly when needed.

Is the service effective?

The service was effective. We looked at four care plans and we saw each person using the service had a support plan based on an assessment of their health and social care needs. For example, one person’s support plan described how care workers were to support the person with eating in a safe way. The person needed support to eat a pureed diet because they were at risk of choking.

New care workers received a formal induction which followed the Skills for Care Common Induction Standard. This sets out the first things care workers need to know when providing care and support. Refresher courses were scheduled on an ongoing basis.

Care workers we spoke with told us that they received training that was appropriate to their individual roles and responsibilities.

Is the service caring?

The service was caring. One person using the service told us: “I wouldn’t be where I am today if it wasn’t for the care and kindness the girls at New Forest Homecare have given me. They have been really good in helping me get back to normal”.

Risk assessments and support plans were reviewed and updated to reflect changes in people’s needs.

Is the service responsive?

The service was responsive. One person using the service said: “I sometimes ask them [the agency] to change my call time because I am going out or to the hospital. Nothing is too much trouble and they always come earlier or later if I ask them”.

One relative we spoke with told us: “We have had a few agencies look after our relative but this one is by far the best. My relative’s needs change regularly but the girls [care workers] are on top of things all the time. They are pro-active and not re-active which is very reassuring”.

Is the service well led?

The service was well led. The providers IT systems were backed up externally and could be accessed if the offices were not accessible due to an emergency situation. This ensured that the agency could continue to operate and the care and welfare of people would be maintained.

The agency had an effective system in place to identify, assess and manage risks to the health safety and welfare of people using the service and others. This included risk assessments of people’s homes to ensure there were no hazards, such as electrical cables, which people could trip on. Guidance was available for care workers on lone working and what to do in the case of an emergency, such as fire or gas escapes.