We carried out an unannounced inspection at Quality Care (North West) Limited on the 12, 13 and 17 October 2016. We contacted people using the service on the 13 and 17 October 2016.

Quality Care (North West) is registered with the Commission to provide personal care. This family run agency has been in operation since 1996 providing domiciliary care services within the borough of Pendle. The range of services provided includes personal care, domestic assistance and a sitting service. The agency office is staffed during the hours of 9:00 am to 5:00 pm, with a 24-hour on-call system for emergencies. At the time of our inspection there were 83 people receiving a service

We last visited Quality Care (North West) Limited on the 10 February 2014. The service was fully compliant in all areas assessed.

At the time of this inspection 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.

During this inspection we found the service was meeting the current regulations.

People using the service received care and support from a team of staff who had been recruited safely and trained to deliver safe and effective care and support. People who completed our survey told us they felt safe from abuse or harm from the staff and they were treated with respect. People we spoke with told us they felt safe in their homes. Staff followed their instructions to gain access to their property and left their homes secure. They told us staff were trustworthy and respected their home.

People using the service and their relatives described the service as very good. They said staff were very respectful, attentive to their needs and treated them with kindness and respect when providing their support. Staff were also described in such terms as being caring and kind, the best, remarkable and lovely people.

Staff had been trained in safeguarding vulnerable people and knew what to do if they suspected any abusive or neglectful practice. Safeguarding procedures were in place to guide and direct staff in reporting any concerns they had. People we spoke with knew what to do if they had any concerns regarding the staff who supported them.

Risks to people’s health, welfare and safety were managed very well. Risk assessments were thorough and informed staff of the actions to take to support people safely. People knew they could contact the agency at any time and had emergency contact details for out of office hours. The service responded well to requests for urgent help.

There were appropriate arrangements in place to support people to take their medicines. People received their medicines as prescribed, by staff that had been trained to do this safely. People we spoke with told us their visits were arranged to ensure they got their medicines at the right time.

Staff knew what to do in emergency situations and had guidance around keeping themselves and people they supported safe. Good arrangements were in place for staff to gain entry into people’s homes without placing them at risk. Staff were provided with protective equipment such as disposable gloves and aprons to minimise the risk of cross infection between people they visited.

Staff were trained in the principles of the Mental Capacity Act 2005. Staff understood the principles of best interest decisions’ regarding people’s care and support and people’s diversity was embraced within their care plans. Care plans were well written and person centred and focused on the needs of people using the service. People’s right to privacy, dignity, choice and independence was considered and reflected in their care plan.

Staff felt confident in their roles because they were well trained

We spoke with five members of staff about how they ensured people who used the service had consented to their care. All were able to tell us the appropriate procedures they took to ensure people had consented to their care and treatment.

We spoke with five staff members about the care they provided to people who used the service. We were told, “I look at the care files and read the care file and diary sheets to see what is going on. I make sure everything is documented properly”. Another told us, “The care files are important, they give you all the information so you know what they (people who used the service) are doing and what they need. I always read them before I do anything”.

We asked the manager about how they ensured checks were taking place in respect of administration of medications. We were told medication administration charts were checked when they were returned to the office and any concerns were acted on immediately. The manager told us this was not recorded formally. We asked the manager to provide us with information on how this would be addressed.

We looked at four staff files and saw there was systems were in place with regards to the recruitment and selection of staff.

We saw there were regular questionnaires sent to people who used the service about the care they received. We saw completed copies of these. We saw they had detailed information about the care given and staffing provided by the service, we saw positive feedback from these.

People using the service told us they were satisfied with the care and support they received from Quality Care (North West). They said, “I think they are very good, we would be hard pressed to get anyone better” and “They do everything we want them to do, they give satisfaction”.

People told us they were involved in planning their care and support package. They told us the care they received was good and that they had care plans which explained their needs and how their support should be provided.

People said they had been given information about the service, which provided useful information and contact details.

People considered they were treated with dignity and said their privacy was respected. They told us the staff were helpful, punctual and well trained. They had had no concerns about their care and treatment, they said felt safe with the staff. They described staff as “Friendly”, “Cheerful” and “Good”.

People told us they knew what to do if they had any complaints and were confident that any concerns would be resolved.

People using the service told us they were satisfied with the support they received from Quality Care (North West) Limited; they made the following comments. “They are brilliant, nice people, no complaints whatsoever, they will do anything”. “Quality Care is definitely the better agency”. “If I had a problem I would just ring them, they will sort out any issues". “No ups and downs, everything is satisfactory”. “I had them before and I was so happy with them I wanted them again”. “I have recommended them to other people”.

People told us they were involved in planning their care and support. They were enabled to make choices and decisions about matters which affected them.

People considered they were treated with dignity and said their privacy was respected. They told us they were encouraged to be as independent as possible.

They told us the care they received was good and that they had care plans which instructed staff on what they needed to when they visited.

People had no concerns about their care and treatment; they said they felt safe with the staff. They said the staff were good, friendly and fine.

People said they were consulted about the service and that checks on visits and practices were being carried out.