Quay care is a domiciliary care agency which providers personal care to people in their own homes. This service provides care and support to people living in one ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. It also provides an enabling service to some people which we do not regulate. The service covers Barnstaple and Bideford areas. Currently they provide personal care for up to 28 people.

This agency changed location in July 2017, so this was the first inspection report to be completed in this new location. Under their previous location the service had been rated as good in all five key areas inspected. This inspection took place on 7 and 14 September 2018.

The registered provider/manager and staff showed exceptional caring towards people they provided a service for. People who used the service and professionals who commissioned the service spoke exceptionally highly about the caring ethos and understanding of the service. People and professionals consistently gave really positive feedback including “I would not use any other agency. This is the best. They know what real care is about. They go the extra mile.” And “I only trust this agency. The carers who come to me are very kind and considerate and know how to help me.” Staff were happy to work for the agency and said the caring was extended to them. One said “The manager is so caring. You can go to her about anything. I really feel valued.” The agency made sure staff were cared for by investing in a private healthcare scheme which allowed staff to access free or discounted health care and this include counselling.

Staff were committed to ensuring people were given the best service possible, sometimes in difficult circumstances. All staff were particularly sensitive to times when people needed caring and compassionate support. Respect for privacy and dignity was at the heart of the service’s culture and values. It was embedded in everything that the service and its staff did. An equality, diversity and human rights approach to supporting people’s privacy and dignity was well embedded in the service.

There were sufficient staff with the right skills and understanding of people’s needs and wishes to ensure all visits were completed. People said staff were friendly helpful and arrived on time. Staff could describe way in which they respected people’s dignity and privacy and worked in a way which showed kindness and compassion. People confirmed this was the case. Comments included “The always show respect and ensure dignity. They are super.”

People were supported to have maximum choice and control of their lives and staff supported

them in the least restrictive way possible; the policies and systems in the service supported this

practice. People's consent to care and treatment was sought. Staff used the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and understood how these applied to their practice. No one was currently under a community DoLS but care plans included detail of how staff should ensure people’s mental capacity was fully considered. Staff were also aware of where relatives was involved and may need to assist in making best interest decisions.

Care and support was person centred and well planned. Staff had good training and support to do their job safely and effectively. The service had invested in electronic care plans which also included electronic daily records. This had helped to improve the overall quality of record keeping and allowed the registered manager and senior team members to access people records remotely if needed.

Risk assessments were in place for each person. These identified the correct action to take to

reduce the risk as much as possible in the least rest