This inspection was carried out on 31 January and 1 February 2018.

Oswestry Care Limited is a domiciliary care agency that provides personal care and support to people in their own homes. It provides a service to older adults, some of whom are living with dementia, and younger disabled adults. Not everyone using Oswestry Care Limited receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’: help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, 83 people were receiving a personal care service.

There was a registered manager in post who was present during our inspection. 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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People continued to receive safe care and treatment. People were protected from the risks of abuse, avoidable harm and discrimination by staff who knew how to identify and report signs of abuse. The provider had safe recruitment procedures to ensure that prospective new staff were suitable to work with people living in their own homes. People were supported by regular care staff who were punctual and reliable.

Risks associated with people’s needs and environment were routinely assessed, monitored and review. Staff were aware of these risks and how to minimise them. The management team monitored any accidents or incidents and took appropriate action to prevent them happening again. The provider had infection control systems in place prevent the risk of infection.

People received support to take their medicine as prescribed to promote good health. Staff monitored people’s health and wellbeing and supported them to arrange healthcare services as and when needed.

People were supported by staff who had the skills and knowledge to meet their individual needs. Staff received training relevant to their roles and felt well supported by management and colleagues.

People were satisfied with the support they received with meals and drinks. People’s nutritional needs were assessed and known by staff.

People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the provider’s policies and systems supported this practice.

Staff treated people with dignity and respect. People found staff to be kind and caring. Staff had formed effective working relationships with people and their relatives. Staff offered people choice and respected their wishes. Staff provided information to people in a way they understood to enable them to make decisions about their own care.

People received care and support that was shaped around their individual needs and preferences. People were supported by regular care staff who knew them well and were able to recognise and promptly respond to any changes. People had not had cause to complain but felt comfortable to raise any concerns with staff of management.

People and their relatives felt the service was well run and would recommend it to others. They found the management team friendly and approachable.

There was an open and honest culture within the service where people, their relatives and staff were given opportunities to put forward ideas for change.

The provider and registered manager had systems in place to monitor the quality of the service and to drive improvements.

Further information is in the detailed findings below

The inspection was carried out on 25 November 2015 and was announced.

Oswestry Care Limited is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of our visit the agency was providing a service to 75 people. The frequency of visits ranged from one visit per week to five visits per day.

There was a registered manager in post who was present during the inspection. 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 felt safe and comfortable with the care and supported provided by staff. Staff knew how to keep people safe from harm and abuse and who to report any concerns to. The provider ensured that there were sufficient staff to meet people’s needs. They completed relevant checks to make sure staff were suitable to work with people who used the service.

Staff knew what action to take in the event of an accident and incident. They would seek medical attention if required and report the incident to the office.

People received support from staff who were skilled and knowledgeable about their role. Staff received regular supervision and felt well supported by management and office staff. Staff felt that they could approach the management at any time for guidance and support.

Staff sought people’s consent before supporting them and respected their wishes when they declined support. Where people had difficulty communicating their needs verbally, staff would look at their body language to establish their wishes or write things down for people.

People received support with food and drink where required. Staff supported people to access health care professionals as and when needed.

People were positive about the support they received. They told us they received support from staff who were patient, kind and helpful. People were treated with dignity and respect. Staff promoted people’s independence.

People were involved in decisions about their care and given choice about how they wanted things done. The service was responsive and changes were made on request.

People were actively encouraged to give feedback on the service. The provider had systems in place to deal with complaints in order to improve the service.

The service had a positive working culture which promoted open communication. People, relatives and staff found the management friendly and approachable.

During our inspection we spoke with people who used the service and their relatives. We spoke with care workers and looked at records. People and their relatives told us, “Carers are friendly, willing and helpful”. Care workers told us, “I enjoy my job, I feel appreciated”.

People’s needs were assessed and care was planned with their full involvement. Care workers were able to tell us about people’s needs and how they supported them. Care records were kept updated and reviewed regularly. This meant care workers had the information they needed to meet people’s needs.

On the day of our inspection there were sufficient care workers on duty to meet the needs of the people who used the service. Care workers were well trained and had a comprehensive induction period before they worked alone with people.

People’s views on the service were sought although the information gained had not been shared with people and care workers. Risks to people were identified and assessed to ensure their safety and welfare.

We spoke with one person who used the service and two relatives. We also spoke with the manager and three members of staff. We made efforts to contact more people and staff but these were unsuccessful.

People and their relatives were very satisfied with the care and support they received from Oswestry Care. They were involved and consulted about the way that care and support was given and reviewed. People were supported to retain their independence as much as possible.

Staff and the service were described as, "Excellent" and "Superb". A relative told us that, "We can't speak highly enough about them. We have nothing but the highest praise for them".

Care plans contained clear guidance for staff on people's needs and how these should be met. This was done in a way that reflected people's individuality and preferences. People were involved in care planning and decision making. Their consent was sought whenever possible, and this was recorded.

Systems were in place to make sure that checks were made when new staff started working at the agency to make sure that they were suitable. Staff felt very well supported by the management team.

The agency supplied people with information about how to raise any concerns and complaints.

Appropriate equipment was provided and serviced by healthcare professionals. Staff were trained so that they could use it safely.

We spoke to the registered manager, the nominated individual, five staff, four people who use the service and two relatives of people who use the service. We looked at 10 care files and other records relevant to the outcomes looked at.

We saw that the agency provided very good detailed information about Oswestry Care to people considering or starting to use the service. People’s needs were assessed before they started using the service to make sure they could be met and they were able to meet the staff who would be providing the care.

People who used the service were very satisfied with the high standard of care they received. They felt safe and confident in using the agency's services. People felt respected and well looked after.

Support was offered to people in a variety of ways to make sure that they were seen as individuals' and their lifestyle choices and preferences were respected.

Care plans contained very good detail about people's needs and clear guidance to staff about how those needs should be met. Plans clearly recorded how staff supported people’s independence and how care was to be delivered in a way that suited the person’s wishes.

Staff were very knowledgeable about what constituted abuse and poor practice and were clear about how to report this should it occur. Polices, procedures and training were in place to make sure that people who use the agency were kept safe and the risk of abuse was known and minimised.

Staff were provided with extensive training, supervision and support by the manager and were confident that they were able to provide the care and support to people who use the agency.

Effective management systems were in place to make sure that the agency was well run. Quality assurance systems were in place to monitor the effectiveness of the service and identify any issues of concern or areas for review.