We carried out this announced inspection on 14 and 15 March 2018. We gave the service 48 hours’ notice of the inspection visit because the location provides a domiciliary care service and we needed to be sure that staff would be at the office. At the last inspection, in December 2015, the service was rated Good. At this inspection we found the service remained Good.

Pendrea Home Care provides personal care to people living in their own homes in the community. It provides a service to older adults in the Bodmin, Wadebridge, St Austell and Bude areas of Cornwall. This includes people with physical disabilities and dementia care needs. The service mainly provides personal care for people in short visits at key times of the day to help people get up in the morning, go to bed at night and support with meals. At the time of our inspection 60 people were receiving a personal care service. These services were funded either privately, through Cornwall Council or NHS funding.

People, and their relatives, told us they were happy with the care they received and believed it was a safe service. Staff treated people respectfully and asked people how they wanted their care and support to be provided. People and their relatives commented, “It makes me feel safe because of their kindness”, “I am pleased with the care my husband has” and “The care is very good, they really look after me.”

The management team ensured there were enough staff to safely meet people’s needs by monitoring the care packages being delivered and only taking on new packages when enough suitably qualified staff were available. Staff rotas were planned in advance and staff were matched to the needs of the people using the service. People told us they received a reliable service and had regular staff who visited them. People had agreed the times of their visits and were kept informed of any changes. No one reported ever having had any missed visits. People told us, “It is a very reliable and good service”, “They are always on time” and “They always phone if they are going to be late.”

Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. Staff were aware of people’s preferences and interests, as well as their health and support needs, which enabled them to provide a personalised service. People who needed help taking their medicines were appropriately supported by staff. Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

Care plans provided staff with direction and guidance about how to meet people’s individual needs and wishes. These care plans were regularly reviewed and any changes in people’s needs were communicated to staff. Assessments were carried out to identify any risks to the person using the service and to the staff supporting them. This included any environmental risks in people’s homes and any risks in relation to the care and support needs of the person.

People’s rights were protected by staff who under stood the Mental Capacity Act 2005 and how this applied to their role. Nobody we spoke with said they felt they had been subject to any discriminatory practice for example on the grounds of their gender, race, sexuality, disability or age.

At the last inspection we found that recruitment checks on new staff were not always thorough or completed before new staff started to provide care for people. At this inspection the necessary improvements had been made and appropriate checks had been completed, before staff were employed, to ensure staff were suitable to work with vulnerable people.

Training records showed staff had been provided with all the necessary training which had been refreshed regularly. Staff told us they had “lots of training” and found the training to be beneficial to their role. Staff said they were enco

We spoke with eight people who used the service and one relative. They told us that every thing was absolutely fine. Several people told us the carers are usually on time and that they often get the same ones, this is good for continuity. One person said the carer had been quite late on occasions. These people said “They will phone us to say why they are late”. Another person said, “I receive good care and am kept informed”. One person said, ”The carers are fantastic, they understand my complex needs, they are a skilled team”. All of the people we spoke with expressed satisfaction with the service provided.

During our inspection, we spoke with the director, manager, two care staff and the administrator. They demonstrated a good knowledge of the care needs of people who received a service and they spoke fondly of each person.

We found peoples’ views and experiences had been taken into account in the way the service was provided and delivered in relation to their care.

We found that people who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse happening.

We saw there were appropriate checks undertaken before staff commenced work for the service.

Staff were supported because they received training and regular supervision and appraisal.

We carried out a visit to the agency office on 14 November 2011.

Many people told us that the staff that visit them are good, but the agency are not good timekeepers, reporting that their visits can be late and on occasion missed completely. People were positive about the carers themselves saying that they had no complaint about them as individuals and the care provided.

Staf told us that training was limited or non-existent, though 2 staff expected to start NVQ training soon. We were told that supervision sometimes took place, but this was not regular and frequent.

The operations manager told us that the agency had a training matrix (providing an overview of all the training all the staff had undertaken); a complaints log, and; a medicine policy and procedure, and that copies could be emailed to the CQC inspector. However, four days after the site visit this had still not been received.

The inspection took place on16 and 23 December 2015 and was announced. The provider was given notice because the location was a domiciliary care agency (DCA) and we needed to be sure that someone would be in. We also gave notice to enable the agency to arrange home visits with people’s consent.

Pendrea Home Care is a DCA providing personal care and support to people living in their own home. On the day of the inspection65 people were being supported by Pendrea Home Care with their personal care needs.

The service had 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 had risk assessments in place. However, some did not include sufficient information for staff about how to minimise risks. The registered manager told us this detail would be added as soon as possible.

The service had a recruitment policy in place but checks on new staff were not always thorough or completed before people started work. The registered manager told us they would improve the system immediately.

People spoke highly about the care and support they received, one person said, "They're all absolutely lovely. I can't fault them." Care records were personalised and staff responded quickly to people’s change in needs. People or, where appropriate, those who mattered to them, were involved in regularly reviewing their needs and how they would like to be supported. People’s preferences were identified and respected.

Staff showed a kind and compassionate attitude towards people. Strong relationships had been developed and practice was person focused and not task led. Staff had an appreciation of how to respect people’s individual needs around their privacy and dignity.

All staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

People had their medicines managed safely. People were supported to maintain good health and staff supported them to contact relevant professionals, such as a GP or a district nurse, if required.

People were supported by staff who confidently made use of their knowledge of the Mental Capacity Act (2005), to make sure people were involved in decisions about their care and their human and legal rights were respected.

Staff received an induction programme which included shadowing experience. On-going training was provided to ensure staff's skills and knowledge were up to date. A staff member told us, "If there's something I don't know, there is always someone in the office who will provide training or just talk you through how to do something."

The service had a policy and procedure in place for dealing with any concerns or complaints. Complaints had been recorded and responded to in line with the policy.

Staff described the management as supportive and approachable. Staff talked positively about their jobs. Comments included, "The work is very rewarding. When one person says, 'Thank you for all you've done.' it makes it all worthwhile,"

There were quality assurance systems in place. Incidents were appropriately recorded and analysed. Learning from incidents and concerns raised was used to help drive improvements and ensure positive progress was made in the delivery of care and support provided by the service.