Oxford Aunts provides personal live in care services to people living in their own houses and flats in the community. It provides a service to older adults. At the time of our inspection 86 people were receiving a personal care service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

The service continued to provide safe care to people. Staff had received training in safeguarding adults and understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place, these included completing checks to make sure new staff were safe to work with vulnerable adults.

Medicines were managed safely and people received their medicines as prescribed.

People's care plans contained risk assessments which included risks associated with peoples care. There were sufficient staff deployed to meet people’s needs.

People continued to receive effective care from staff who had the skills and knowledge to support them. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health.

The service continued to provide support in a caring way. People benefited from caring relationships with staff who treated them with dignity and respect. People were involved in their care and supported to remain independent.

The service continued to be responsive. People received personalised care by staff who understood people's individual needs and preferences. People's changing needs were responded to appropriately.

The service continued to be well led by a registered manager and care provider who were open, honest and transparent. The registered manager continually monitored the quality of the service.

We undertook an announced inspection of Oxford Aunts Domiciliary Care Agency (DCA) on 9 November 2015. We told the provider two days before our visit that we would be coming. Oxford Aunts provides personal live in care services to people in their own homes. At the time of our inspection 84 people were receiving a personal care service.

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 we spoke with told us they felt safe. People were supported by staff who could explain how they would recognise and report abuse. Risks to people were managed and reviewed. Where people were identified as being at risk, assessments were in place and action had been taken to reduce the risks.

People benefitted from staff who understood and implemented the principles of the Mental Capacity Act (2005). The MCA is the legal framework to ensure that where people are assessed as lacking capacity to make decisions for themselves, decisions are made in their best interests. Care staff we spoke with had completed training on the MCA.

There were sufficient staff deployed to meet people’s needs and staffing levels were matched to the individual needs of people. Records relating to the recruitment of new staff showed relevant checks had been completed before staff worked unsupervised at the service.

Where people needed support with medication we saw that records were accurately maintained and fully completed which showed people received the medicine they needed when they needed them. People who needed assistance with their medicine were supported appropriately by trained staff.

People told us staff knew their needs, supported them appropriately and had the skills and knowledge to carry out their roles and responsibilities. Staff received regular supervision and had access to development opportunities.

People and their relatives spoke highly of the care that was delivered by the service. Staff we spoke with knew the people they were caring for and supporting, including their preferences and personal histories. People were supported to maintain their faith and religious needs.

People told us they felt involved in their care. People’s needs were assessed prior to receiving care to ensure their needs could be met and people received personalised care. Care records contained details of people’s personal histories, likes, dislikes and preferences. The service sought the advice and worked with healthcare professionals to meet people’s needs.

The service sought people’s opinions through a yearly satisfaction survey and a quality assurance questionnaire following each placement. Where people raised issues the service took action to improve the service.

There was an open and caring culture and staff spoke positively about the registered manager and care managers. Accidents and incidents were recorded and investigated. Information was logged onto an ‘Improvement diary’ allowing the registered manager and senior staff to review this information collectively to look for patterns and trends across the service. Information was used to improve the service.

Regular audits were conducted to monitor the quality of service. These were carried out by the provider. Audits covered all aspects of care including, care plans and assessments, risks, staff processes and training. Information was analysed and action plans created.

We spoke to five people who use the service, three relatives or advocates and three members of staff. We reviewed a range of documents including care plans and staff files. These were detailed and updated.

People were positive about the support provided. One person said “I’ve always been sent very good people.”

People told us that the service helped to keep them safe.

People we spoke to expressed satisfaction with the service. One person told us “They look after you and they look after the carer as well.”

An advocate told us that the service was “very responsive to anything I say”.

Consent was sought from people who used the service. We spoke with four people who used the service who said staff “ask me what I want doing”. We spoke with four members of staff; one said “I explain what I’m going to do. I ask if it’s okay and if they are ready”. We found staff had a good understanding of mental capacity. We spoke with four relatives/representatives of people who used the service who said they were involved in making decisions.

Peoples’ needs were initially assessed and reviewed regularly. We looked at eight client files and saw evidence of this. One person said “I have plenty of opportunity to say what I think”. Staff we spoke with said care plans were reviewed regularly or when a person’s needs changed.

Appropriate arrangements were in place for the management of medicines. Staff received annual training and competency checks. We saw evidence of this in staff files. Staff we spoke with showed a good understanding of the service’s medication policy and their responsibilities. One relative said “I am very confident in their ability to administer medication”.

There were appropriate recruitment and support procedures for staff. Staff files confirmed that the necessary checks had been undertaken and staff received regular training and supervision.

People who used the service were provided with details of the complaints procedure in an information leaflet. We saw evidence that complaints were dealt with in line with the service’s policy.

People we spoke with were very positive about the quality of the care they received. People told us that they knew who to contact within the agency and that the staff were well trained and knowledgeable about their care needs. People told us that they had a choice in who provided their care and could request a change if care was not being given in the way they wanted it. People we spoke with told us that their care was regularly reviewed and that if there were problems the proprietor or senior manager would look into it personally. People told us that they would be listened to and that action would be taken if they had a compliant.