Pee Wee Personal Home Care Limited is a domiciliary care agency registered to provide personal care for people living in their own homes. The agency provides services to people in Torrington and the surrounding areas. At the time of the inspection 23 people were being supported by the service. The service employed 14 care staff.

This inspection was undertaken on 13 and 21 July 2017. We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a service to people in their homes; we needed to be sure that the registered manager would be available at the office.

We last inspected the service on the on 28 and 30 September 2015. At that inspection we found the provider was not meeting all of the regulations we inspected. The need for improvement was identified in relation to the management of medicines and staff recruitment. At this inspection we found improvements had been made.

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.

People said they were safe using the service because it was reliable; staff were well trained and caring. Comments included, “I am more than happy with Pee Wee. They (staff) are all very pleasant and I trust them…” and “It is very nice having them (staff) coming in and out. It is rather reassuring…” A relative said, “The service is certainly safe. Never a problem. I know (relative) is very well cared for.”

There were sufficient numbers of staff employed to provide people with their planned service. People said they had never experienced a missed visit; that staff arrived on time and stayed the expected length of time.

Staff were knowledgeable in relation to safeguarding people from abuse and they knew how to keep people safe from avoidable harm. Risks to individuals had been identified and there was guidance for staff on how to keep people safe. Where people were assisted with their medicines this was managed safely.

People’s right to make decisions for themselves was respected and staff sought consent when delivering care and support. People were supported to remain independent and were fully involved in how they wanted their care and support to be provided.

People were supported to ensure they had a sufficient amount of food and fluid to promote their wellbeing. People received support from staff who understood and responded to their health needs.

The service provided was personalised and flexible. People liked the staff who provided their support very much and felt their dignity was promoted and privacy respected. They told us, “This service is excellent. The staff are very friendly, always ask how I am…” and “Staff have a really good approach; they are empathic and they understand how my illness affects me. They are very caring. I can’t fault them…”

The service was well managed by the registered manager and a director of the company.

The inspection took place over two days on 28 and 30 September 2015. The provider was given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. We told the provider two days before our inspection that we would be visiting. We did this because the manager is sometimes out of the office and we needed to be sure that they would be available.

Pee Wee Personal Home Care Limited is a domiciliary care agency registered to provide personal care for people living in their own homes. This was the first inspection of the service following registration with the Care Quality Commission. At the time of the inspection the agency was providing a service to 14 people living in their own homes. The service was supporting people with a variety of care needs; including older people, and people with a mental health diagnosis. Care and support was co-ordinated from the office, which was based in Torrington. The service employed six care staff.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

The provider did not have adequate systems in place to ensure the safe handling, administration and recording of medicines to keep people safe. However, the provider was addressing this during the inspection and staff training had been organised.

The provider had not undertaken all the checks required to make sure people who were employed by the service were suitable to be employed before they started working with people using the service. There was a system in place to support new staff when they commenced employment, however staff would benefit from additional training, which the provider was organising at the time of the inspection.

The provider was embedding a system to monitor the quality of the service provided. There was regular contact with people using the service to see if they had any concerns or comments. The registered manager also carried out spot checks of the staff to ensure they were providing care safely. However, the audits or quality checks that were undertaken were not formally documented to evidence what had been identified, what required attention and who was responsible for ensuring any improvements. The provider had developed an action plan in July 2015 which set out the action they intended to take to strengthen how they monitored the quality of the service. This included the use of matrixes for training, reviews, and spot checks as well as implementing more robust forms of audit trails.

People who used the service said they received high quality care and all were happy with the care and support provided. People spoke highly of the staff and registered manager. Comments from people using the service and their relatives included, “I have very kind carers; always cheerful…very polite…I can rely and depend on them…”; “This is really a brilliant, wonderful service”; “The service is really perfect…exceptional. We couldn’t manage without them” and “…I thank my lucky stars I have them…”

Arrangements were in place to maintain staffing levels to ensure people received their agreed care and support. People confirmed the service was reliable; no visits had been missed, staff arrived when they were expected and stayed the agreed length of time. People said they had a regular team of staff caring for them, which had enabled them to develop good relationships.

People said they felt safe using the service and had no concerns about the way they were treated or supported. Risks to people’s well-being were assessed and managed. Staff were aware of the signs of abuse and they knew what to do should they witness any concerns, or should concerns be disclosed to them. This helped to protect people from the risk of abuse. Measures were in place to monitor and respond to people’s health care needs. Where appropriate people were supported with eating and drinking.

A complaints procedure was in place, which people confirmed they were aware of. People’s concerns and complaints were listened to, addressed in a timely manner and resolved quickly.

People’s needs had been assessed before their care had commenced. People and their relatives (where appropriate) confirmed they had been involved in creating and updating their care plans. All felt involved in making decisions about the care and support they needed.

People using the service and their relatives said the service was well managed and efficient. Comments included, “The manager is excellent…she listens and will accommodate any requests or changes” and “The manager and staff are very professional. We can’t rate them highly enough…”

During our inspection, we found breaches in two areas of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.