We carried out this inspection on 22 and 24 January 2018. The inspection was announced a few days in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. At the last inspection, in November 2015, the service was rated Good. At this inspection we found the service remained Good.

Restgarth Domiciliary Care (DCA) provides personal care to people living in their own homes in the community. It provides a service to older adults in the Liskeard, Looe and surrounding 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 52 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. People and their relatives commented, “On the whole a good service”, “Perfectly happy” and “Very happy with the service I get.”

Staff treated people respectfully and asked people how they wanted their care and support to be provided. 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, “Staff are very good”, “Staff are patient and don’t rush me” and “I need staff who know me well and I have regular staff who understand my needs.”

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.

The service had robust recruitment practices, which meant staff were suitable to work with vulnerable people. People were supported by stable and consistent staff teams who had received appropriate training specific to meet their needs. 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 encouraged to attend training to develop their skills, and their career.

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. There were sufficient numbers of suitably qualified staff available to meet the needs of people who used the service.

Staff completed a thorough induction programme prior to providing people's care. The Induction of new members of staff was effective and fully complied with the requirements of the Care Certificate. People told us they were introduced to new staff before they supported them in their home. People confirmed they had regular staff to support them and had built up positive relationships with care staff.

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 discr

The inspection took place on 25 and 26 November 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.

Restgarth DCA provides a personal care service to people living in their own home. On the day of the inspection over 100 people were supported by the agency 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’s care records contained information that described what staff needed to do to provide personalised care and support. Staff responded quickly to people’s change in needs. Where appropriate, friends, relatives and health and social care professionals were involved in identifying people’s needs. People’s preferences, life histories, disabilities and abilities were taken into account, communicated and recorded.

People’s risks were monitored and managed well. The agency had policies and procedures in place which were understood by staff to help protect people and keep them safe. However some staff were not always fully aware of the agency’s Lone Worker policy.

People were supported and encouraged to maintain a varied and healthy balanced diet.

People had their medicines managed safely and people told us they received the prompts required to help ensure they received their medicines as prescribed.

People, relatives and staff were encouraged to be involved and help drive continuous improvements. This helped ensure positive progress was made in the delivery of care and support provided by the service.

The service sought feedback from people and encouraged people to share their concerns and complaints. The registered manager investigated any complaints or concerns thoroughly and used the outcome as an opportunity for learning to take place.

People were kept safe and protected from discrimination. All staff had undertaken training on safeguarding from abuse and equality and diversity. Staff displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm.

Some staff had received training in the Mental Capacity Act. These staff displayed an understanding of the requirements of the act, which had been followed in practice.

There were sufficient staff to meet people’s needs. Staff were trained and had the correct skills to carry out their roles effectively. The service followed safe recruitment practices to help ensure staff were suitable to work with vulnerable adults. Staff described the management as very open, supportive and approachable. Staff talked positively about their jobs and felt motivated to provide quality care.

There were effective quality assurance systems in place to help drive improvements and ensure positive progress was made in the delivery of care and support provided by the service.