This inspection took place on 26 October 2016 and was announced.

Peace of Mind Homecare Services provides a domiciliary care service. It is registered to provide personal care to people living in their own homes. The service provided personal care to 96 people on the day of our inspection.

Two registered managers were in post and were 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.

People felt safe with the care and support they received from staff. Staff were supported to and understood how to take appropriate action to ensure people were protected from any harm or abuse. Risks to people were assessed and plans were in place which staff followed to make sure people were kept safe within their own homes.

People were supported by staff who had been checked to make sure they were suitable to work in their homes. Employment and criminal records checks were carried out on all staff before they started work at the service. Staffing levels were kept under review and people saw the same staff regularly which helped to make sure they had consistency of care.

Staff had the skills and knowledge to understand and support people's individual needs. These skills were kept up to date through regular training. Staff were supported by their line managers and colleagues and could get help and support if they needed it.

People were happy with the standard of personal care and support they received from the service. People felt staff were caring, kind and considerate towards them. They felt listened to by staff and felt they were involved in what happened with their own care and support.

People’s right to privacy and to be treated with dignity was maintained by staff, particularly when receiving personal care. People were supported to do as much as they could and wanted to do for themselves to keep them independent in their own homes.

Staff asked people’s permission before they helped them with any care or support. People’s right to make their own decisions about their own care and treatment were supported by staff.

Staff regularly discussed people’s needs to identify if the level of support they required had changed and their care plans were updated accordingly. People’s care was individual to them and their needs and took into account their preferences and views.

People were encouraged to give their opinions on the care they received. They were confident to raise any concerns or complaints with staff and management and that these would be addressed. The provider responded to complaints in accordance with their own complaints procedures.

The provider and registered managers had created a positive culture which benefitted both people and staff. Staff understood their roles and the values of the service and worked to provide the best care they could to people. Systems were in place which enabled the provider to monitor the quality of service provided. Resources were made available to help drive continuous improvements.

At the time of our inspection the provider did not have a registered manager in post. The manager had been in post approximately three weeks when we carried out this inspection.

Staff we spoke with told us that they had seen improvements in the service since the new manager had been in post. This included improved schedules where calls had been grouped in areas. This meant staff covered calls that were close together.

Everyone we spoke with told us they had a copy of their care plan in their home and that it was updated regularly. People told us that staff treated them with respect and always ensured their dignity was maintained. People also told us that they felt that the support they received from the service met their needs. Comments included, “They are grand, we are really in safe hands and we look forward to them coming. They all know what to do. I am very grateful to have them” and, “They are all very good”.

Suitable recruitment checks were completed that ensured people were cared for and supported by qualified, skilled and experienced staff.

The provider sought people's views periodically and completed assessments of risks to assess and monitor the quality of the service provided.

Everyone we spoke with about this agency was very complimentary about the service that they received.

People told us that they took responsibility for making their own decisions about their care package and said that they had consented to the support that they received. Everyone felt in control of their care. When people were unable to do this they had the support of family members.

People said that their assessed needs were met in ways that they preferred. They said that they were encouraged as far as they were able to remain independent and they valued this.

Everyone we spoke with felt safe and well supported. People gave examples of how they had been reassured when staff had used equipment to help move them.

People were protected because staff knew what constituted abuse and were confident to recognise and report it.

Overall, staff recruitment files demonstrated that staff were suitable to work with vulnerable people. We found that improvements were needed so that the agency could demonstrate staff were physically and mentally fit for the roles that they were employed to carry out.

The agency had a complaints procedure that people were aware of. People told us that they would be confident to share their worries and concerns with staff or managers.

We carried out this review of compliance to see if the agency had made improvements following our visit in April 2011 when we told them that they had to make changes in relation to medication, training and monitoring the quality of the service provided. At the time of our last visit the manager was new in post.

We received an action plan following our April visit that told us how improvements were going to be made. At the time of this review we looked to see if the actions had been achieved. We found that the agency had made big changes to processes and we considered that they were compliant with the essential standards of quality and safety assessed during this review.

As part of this review we spoke with four people who received a service, five staff and the manager and training manager. We visited the office and looked at records and monitoring tools.

People who received a service from Peace of Mind Homecare Limited (to be referred to throughout this report as Peace of Mind) told us that were very satisfied with the service that they received. One person told us that they provided an, “Excellent service”.

Although people we spoke with did not need support to manage their medication we looked at processes in place to support people who do. The process was now simpler and more straight forward. As a result fewer mistakes were being made meaning that people received a safer service. Staff felt well trained in relation to the administration and recording of medication and effective checks were in place to ensure that processes were understood and followed.

People told us that they were supported by well trained and knowledgeable staff who could meet their needs. Staff told us that training opportunities had increased and the quality of the training had also improved. One person told us that they “Felt well equipped to do their job”.

The agency had introduced a number of measures to monitor and review the quality of the service provided. Measures were proving effective and were being embraced by people who received a service and the staff that supported them.

People who receive a service from Peace of Mind Homecare Limited (to be referred to throughout this report as Peace of Mind) told us that overall they were satisfied with the service that they receive.

People said that, overall, the staff who support them listen to them and meet their needs how they prefer.

People we spoke with understood that they were in control of how their care and support needs were met and one person said that if they request something different that the staff will accommodate them.

Everyone we spoke with said that staff always respect their privacy and dignity. People told us that the carers who are currently supporting them are polite, respectful and caring.

Although people told us that they are currently receiving a good service from the agency it was evident that people have had mixed experiences over the last twelve months. People went on to say that, "Things have now settled down a bit”.

Overall people felt that staff were well trained to meet their needs, however four of the five people who receive a service and two of the four relatives suggested that the some staff were, “Inexperienced” and not as well trained and this affects the quality of the care they receive. Some issues in relation to the quality of the training provided by the agency were identified at the time of our visit.

People told us that they would contact the office if they had any concerns or worries about the care they received. Care staff told us that they feel confident to recognise and report abuse. The majority of people who had complained about the service were satisfied with the responses they received.

Of the five people who receive a service and the four relatives we spoke with as part of this review no one said that they have been contacted by the office to ask them their opinions of the service provided. This suggests that the agency’s quality assurance systems need to be reviewed.