Origin Spinal Injury Care provides 24-hour live-in care for people with spinal injuries. Services are specifically designed for those people with a spinal injury, and undertaken by staff who have had specialist training. People who use the service are not ill, but they are disabled, and the carer's role is to make independent living a reality by working with the service user to overcome the obstacles of day-to-day life. The service operates nationally in the United Kingdom and Eire. When we undertook this inspection the service was supporting 37 people on a permanent basis and approximately nine people as and when required.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was 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.

We spoke with seven people supported by the service. They told us staff who supported them were polite, friendly, caring and well trained in spinal injury care. They told us they received patient and safe care and they liked the staff who supported them. Comments received included, “My personal assistants are extremely caring and conscientious staff. They are well informed about my needs.” And, “I have very good staff supporting me. They are competent, well trained, friendly and helpful. I feel comfortable and safe in their care.”

Procedures were in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs.

People who used the service were asked their views on staff performance to enable effective supervisions to take place. Feedback to staff was carried out to enable continuous improvement and development to take place.

Staff knew people they supported and provided a personalised service. Care plans were organised and had identified the care and support people required.

The service had safe infection control procedures in place and staff had received infection control training. Staff spoken with confirmed they had been provided with protective clothing such as gloves and aprons as required. This reduced the risk of cross infection.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed 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 support this practice.

People's care and support was planned with them. People told us they had been consulted and listened to about how their care would be delivered.

Staff supported people to have a nutritious dietary and fluid intake. Assistance was provided in preparation of food and drinks as people needed. The people we spoke with during the inspection told us they were happy with the support th

We spoke with a range of people about the agency. They included the manager, staff, and people who received a service. This helped us to gain a balanced overview of what people experienced using the agency.

People who used the agency told us they provided a good service. Comments included, “The staff are very good. They go over and above sometimes”.

We looked at the support documentation held by the provider and used this information to assess that standards of quality and safety were being met. We found there were detailed support plans in place that enabled staff to provide the level of support needed. Staff we spoke with told us the information they received aided them to provide a specialist service. Service users received a level of care designed to meet their individual needs. Comments included, “This is a good service to work for. It is really is rewarding”. Also, “Clients get the best service because it is well planned and delivered to clients in the way they want”.

Current medication practices did not take account of safe administration and recording. We spoke with the manager about this. They told us in order to ensure medication management was safe, a review of the procedures was taking place in order for new systems to be put in place. People we spoke with told us they felt it was important to be independent in their lives and this included taking their own medication. However they did accept the agency was required to make sure practices were safe and records maintained.

Staff told us they had been through a range of checks to ensure they were suitable to work with people in their own homes. One person told us, “All the checks were done and I had an intense training programme before I actually began to work with my client”.

We spoke with two people who used the service. They told us, "I am very satisfied with the service. I tell them what I want and they provide it" and "I have used Origin for many years and I am very satisfied with the service".

People who used the service made the decisions on what care they needed and required.

Plans of care were developed with people who used the service and in some examples we saw they wrote the care plan.

People could contact the head office whenever they felt it was necessary and voice their concerns if they had any. At the time of the inspection the two people we spoke with did not have any concerns.

There was a thorough recruitment procedure to provide people who used the service with a suitable staff member.

We spoke to the registered manager; two office based staff members and talked to two staff members on the telephone. In addition we spoke to two people by telephone, to gain their views on the service they receive. By looking at surveys on individual files during the site inspection it also provided us with an overview of the experiences people have had using the service.

Comments we received were very positive and included, "Brilliant service can’t imagine anything better”". Also, "I have continuous support from the same staff member, the service couldn’t be better”. “They are very professional in how they deliver the support, and I think the office staff are always courteous and patient”.

People we spoke to told us they like the way they very much lead the development of their support package. Comments included, “I like the way I can work with the agency to get the package I need. They are very open to ideas and they always try and match the staff to meet my needs”.

Evidence we received by talking to staff members demonstrated this is a very good agency to work for and staff told us they felt supported to carry out their role. One staff member said, "My training was centred on specific spinal injuries and trauma, as well as other areas, so I felt confident when I went to my first job”. Also, “I feel really supported and there is always someone to speak to if you need them”.

Staff spoken to had a good awareness of individual care and support needs and the importance of treating people with respect and dignity. A carer spoken to said, "I think it’s really important we respect people’s rights to dignity and to help them maintain this”.

Other organisations we spoke to about the agency told us had no issues about the service it provides.

This inspection was carried out on the 06 and 22 January 2016. Origin Recruitment Limited is registered as a domiciliary care agency with the Care Quality Commission. We last inspected the service in October 2013. We identified no breaches in the regulations we looked at.

Origin Recruitment Limited provides 24-hour live-in care for people with spinal injuries. Services are specifically designed for those people with a spinal injury, and undertaken by staff who have had specialist training. The carer's role is to make independent living a reality by working with people to overcome the challenges of day-to-day life. The service operates nationally in the United Kingdom and Eire. An out of hours contact number is provided for use in the event of an emergency.

As the agency is small we gave 24 hours’ notice of our inspection. This was because the registered manager and managing director are involved in the day to day running of the agency and we needed to ensure they were available. The office is based in Lancaster with parking available at the building. At the time of the inspection Origin Recruitment Limited provided support to 45 people.

There was a manager who was registered with the Care Quality Commission. 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 who used the service told us they were happy with the care and support provided. People applauded the way in which Origin Recruitment Limited enabled them to live independent lives.

There were systems in place to ensure people who used the service were protected from the risk of harm and abuse. Staff we spoke with were knowledgeable of the action to take if they had concerns in this area. They told us the registered provider encouraged concerns to be raised.

Staff were knowledgeable of peoples’ assessed needs and delivered care in accordance with these. People who received care and support told us they were happy with the care provision from Origin Recruitment Limited.

People’s nutritional needs were considered as part of the assessment process and reflected within care documentation.

People told us they worked in partnership with Origin Recruitment Limited. They told us they were empowered to manage their own healthcare.

There was a culture of learning within the organisation. The managing director had designed specialised training to enable staff to provide support which met peoples’ needs. Staff and people who used the service commended this. People who used the service were asked their views on staff performance to enable effective supervisions to take place. Feedback to staff was carried out to enable continuous improvement and development to take place.

People were consulted and involved in the care planning process to ensure support was arranged to meet their needs and wishes.

There were arrangements in place to ensure people received their medicines safely.

Sufficient recruitment checks were carried out prior to a staff member starting to work with the agency. Staffing was arranged to ensure people received care and support at the time they wanted.

In addition to the registered manager, there were three care managers in place. The care managers were responsible for the effective co-ordination of staff. They engaged with people to ensure their needs and wishes were assessed and understood.

There was a complaints policy in place, which was understood by staff and was available to people who used the service. People were encouraged to give feedback to staff through telephone conversations, face to face meetings and quality surveys.

There were a range of quality audits in place to identify if improvements were required. People were encouraged to give feedback on the service through telephone calls and quality surveys.

Staff spoke professionally and respectfully about the people they supported. They told us they were committed to enabling people to live the lives they chose.