This announced inspection took place on the 5 July 2018. It was announced 48 business hours in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. Our last inspection of the service was carried out on 16 October 2015 2015. At that inspection we rated the service as good. At this inspection we found the service remained good.

Penwith Respite Care (PRC) is a Domiciliary Care Agency that provides care and support to adults, in their own homes. The service provides help and support with people’s personal care needs in the Penzance and surrounding areas. The packages of care that PRC provide range from 30 minutes a day to 24 hour care dependant on the person’s care needs.

PRC alongside the domiciliary care service, run a café in the local community and provided outreach support. Therefore, not everyone using PRC receives 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.

The provider had developed strong links with the local community. They worked alongside other organisations to ensure they followed current good practice in the delivery of people's care. The management team had a role in promoting the importance and value of social care locally. Strong links with the community had been formed via the café. People told us that they were supported by staff to meet with friends in the local café, which reduced social isolation. Some people worked at the café with support from staff which enabled employment opportunities.

At the time of our inspection 33 people were receiving a personal care service. Support is provided to people with a physical or learning disability from the age of 18 tears to older persons. These services were funded either privately or through Cornwall Council or NHS funding. There were 29 staff employed some of those were office based to coordinate and manage the service.

People were extremely satisfied with the quality of the service they received and the caring approach from staff. People told us; "They are friendly, reliable, always on time and thoroughly conscientious.” Relatives were also complimentary, commenting “I had trouble finding the right care for my [relative] and at last she’s got it. They are amazing, they are adaptable, local, understand [relatives] needs that no one else has and if there is a emergency they help out.” Another relative said “The staff know [person’s name] so well, I know that staff look after her well and I don’t need to worry anymore, I can relax and know she is being cared for by caring and competent staff.”

People told us they had not experienced a missed care visit. The service had robust and effective procedures in place to ensure that all planned care visits were provided. The service's visit schedules were well organised and there were a sufficient number of staff available to provide people's care visits in accordance with their preferences.

People told us that their visits were on time but there were 'rare occasions' when care staff could be late for their planned visits. However, people, and relatives, did not have a concern regarding this as they understood that any lateness was due to care staff needing to provide extra support to a person in an emergency or due to travel issues, especially in holiday seasons. People told us that PRC office staff would phone them if a care worker was going to be late which gave them reassurance that their visit would continue. PRC operated an on-call system outside of office hours. Care staff told us managers would respond promptly to any queries they might have.

People received care and support from a consistent team of staff with whom they were familiar. Staff arrived on time and stayed for the full time allocated. People spoke positively about the staff that supported them and

PRC Outreach is a domiciliary care agency that provides personal care for people in the Penzance area of Cornwall. The service predominantly supports adults with learning disabilities and some older people with complex care needs. At the time of our inspection the service was supporting 26 people. Some people had short visits at key times of the day to help them get up in the morning, go to bed at night and give support with meals. Other people received longer visits to support them with their daily lives and other people received a 24 hour supported living service. A supported living service is one where people live in their own home and receive care and support to enable them to live independently.

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.

We carried out this announced inspection on 16 October 2015. The service had not been previously inspected at its current location. When last inspected at the previous address the service was found to be fully compliant with the regulations.

People said they felt safe and told us; “they [staff] are very nice people” and, “they are stars, they are angels really.” People’s relatives told us, “I have no concerns leaving [my relative] in their care, they are a really good crowd.”

Risk assessment processes were designed to ensure people’s safety while enabling people to take risks if they wished. Staff understood local safeguarding procedures and had received training in how to recognise and report abuse. PRC Outreach was able provide emergency support to individuals if their family or personal carer became unwell and one persons’ relative said, “I fell and they came and stayed on a 24 hour basis until family arrived.”

There were sufficient numbers of suitably qualified staff available to meet people’s needs and respond flexibly to requests for changes to planned care visits. People received care from consistent small staff teams who knew them well and had the skills to meet their needs. Peoples’ relatives said, “[My relative] does not like new people, it has been an absolute godsend, the consistency is great” and, “the managers ensure new staff are always introduced slowly so they get to know each other.” Staff told us they were well supported by their managers and that their training needs had been met.

PRC Outreach’s recruitment processes were robust. New staff received formal induction training in line with current best practice and shadowed experienced staff for significant periods before providing care independently.

People’s care plans were personalised and sufficiently detailed to enable staff to meet individual’s specific care needs. Staff told us, “the care plans are quite comprehensive” and the registered manager described how the current care plan format had been developed to enable people to make choices about their routines and which activities they engaged in each day. People and their relatives were involved in care plan review meetings and told us, “we have a meeting each quarter to talk about any changes.”

People’s relatives told us they had complete confidence in the highly flexible support provided by PRC Outreach. Relative’s comments included; “if they say they will do it they will do it. It is absolutely brilliant”, “I know I can rely on them” and, “nothing is ever too much trouble for them.

The service supported and encouraged people to develop and maintain their independence. This support enabled people to live full and meaningful lives within the local community. One person told us, “They helped me decorate my flat” and a staff member described how they had supported a person who used a wheel chair to abseil down a cliff.

People and their relatives consistently told us that PRC Outreach was well led and that they would recommend the service without hesitation. Managers and staff spoke passionately about the people they supported and took pride in describing people’s achievements and successes. Staff told us, “I believe in what I do and I believe in this organisation”, “I try to give people the best day I can” and, “it’s small and works by meeting people’s individual needs.”

PRC Outreach operated “Poppies” a community resource including a café, meeting rooms and “Changing Places” toilet facility. Poppies provided a meeting place for people who used the service, a venue for community events, voluntary work placements and an opportunity for further community integration. One person told us, “I meet my friends here for a cup of tea” and we saw people chose to regularly visit “Poppies” to meet up with their friends and care staff.

Managers and staff understood the requirements of the Mental Capacity Act 2005 and how to make sure the legal rights of people who did not have the mental capacity to make decisions for themselves were protected.

PRC Outreach worked effectively with other care providers and health professionals to ensure people’s specific care needs were met. Any guidance provided by professionals was incorporated into people’s care plans.

The service was committed to supporting people’s individual needs and routinely provided informal additional support to assist people to live independently. On the day of our inspection two people visited the service for informal support and this was provided immediately.

The service had effective quality assurance systems in place and regularly received positive feedback and compliments from people who used the service and their relatives. Information was shared securely using mobile telephones and daily care records were sent to managers at the end of each care visit. These records were routinely audited by the services managers to ensure they were fully aware of any changes to people’s care needs.