We carried out this inspection on 8 and 9 January 2018. The inspection was announced a few days advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. At the last inspection, in October 2015, the service was rated Good. At this inspection we found the service remained Good.

Rowans Domiciliary Agency (DCA) provides personal care to people living in their own homes in the community. It provides a service to older adults in the St Agnes, Perranporth and Mount Hawke 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.

Not everyone using Rowans DCA 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. At the time of our inspection 20 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, “I am very happy with the service, they are doing a good job”, “Brilliant service, it has been life changing for my husband” and “Very good, very pleased with the help.”

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, “The timings are good” and “Someone has always turned up and they let me know if they are going to be late.”

Staff treated people respectfully and asked people how they wanted their care and support to be provided. People and their relatives spoke positively about staff, commenting, "[Person] gets on with all the carers” and “Staff are really nice.”

We found 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.

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.

The service had robust recruitment practices, which meant they were suitable to work with vulnerable people. 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. Management provided staff with appropriate training and supervision. There were sufficient numbers of suitably qualified staff available to meet the needs of people who used the service.

People’s rights were protected by staff who under stood the Mental Capacity Act 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.

There was a positive culture within the staff team and staff spoke passionately about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The register

Rowans Domiciliary Care Agency (DCA) provides support to people in their own homes in the St Agnes, Perranporth and Mount Hawk area of Cornwall. This includes people with general health needs and mental health needs. At the time of our inspection Rowans DCA was providing support for up to thirty people.

This inspection took place on 21st October 2015. The service was previously inspected in December 2013 when it was found to comply with the requirements of regulations.

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.

People were kept safe and their care needs were met. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. People and their relatives told us they had regular contact with their care worker and the manager of the service. They told us “It’s all very flexible and we get [name of staff] all the time so we get to know who is coming through the door”.

People told us they felt safe and secure when receiving care. People received consistent support from care workers who knew them well. People told us, “[Staff member] is marvellous. Don’t know what we would do without her” and “Always on time with a cheery smile. Very good service”.

Care plans were available for all of the people who received care and support from Rowans DCA. Each person’s care plan was up to date and included sufficient information to enable staff to meet their care needs. One staff member said, “The information we get is very good. We also get training in areas where there are special requirements”. People’s feedback was valued by the service. The most recent survey confirmed people were happy with the service they received.

Staff received training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to meet people’s care and support needs. One staff member said, “I hadn’t done this sort of work before but I got a lot of support and training” and “The support we [staff] get is really good and encourages us to do more training”.

Staff told us they were supported by the registered manager and the on- call arrangements provided people and staff with appropriate support when the service was closed.

Recruitment systems were robust. Any necessary pre-employment checks had been completed. Staff received a full induction to understand their role and to ensure they had the skills to meet people’s specific needs. This helped ensure people received care and support from staff who were competent and well matched to the role.

Audit systems were in place to monitor and manage how care and support was being delivered and took account of accidents and incidents, as well concerns and complaints. These systems acted as early indicators of themes or trends which might affect individuals using the service or staff supporting people.

We visited the service on 13 March 2013 and telephoned people and relatives of people who used the service after our inspection.

We gathered evidence of people’s experiences through speaking with one person who used the service. We also spoke with three relatives of people who used the service. We spoke with three members of staff who supported people.

People and relatives we spoke with told us that the care received matched the care that was discussed with them. They told us that they were involved in planning the care and that reviews were held to reassess their needs. We saw relatives had provided information for people's care plans.

We saw that the care plans were person centred and reflected people’s needs. This meant that the care plan was based on the needs of the person. We saw that people’s needs were reassessed and where necessary the care plan was updated. We saw that people's likes and dislikes were clear within their care plans.

People and relatives we spoke with told us that staff were friendly and supportive. We saw there were regular members of care staff who provided people's personal care. Continuity of staff should mean that people receive their care consistently as staff have an increased understanding of people's needs.

We spoke with staff about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding abuse.

We spoke with seven people who used the service or their relatives by telephone during the inspection. The people we spoke with were highly complimentary of the care provided by Rowans Domiciliary Agency. Comments included, “brilliant”, “I think they are wonderful, I really do”, “excellent, I know X is safe and taken care of” and “I wouldn’t want them to change”.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people receive and there was an effective complaints system available.