About the service: Rysvil Care Services Limited is a domiciliary care agency providing personal care people in their own home. The service was providing personal care to 43 people at the time of the inspection.

People’s experience of using this service:

People told us they felt safe and thought that staff were kind and caring.

The registered manager had systems and processes in place ensuring risks were well managed and care was personalised and reviewed.

Staffing levels, skills and experience were suitable to meet the needs of people.

The provider implemented safe systems for the management of medicines which included staff training and assessments of staff competency.

Staff had a good understanding of preventing the spread of infection by using the protective equipment and good hand hygiene.

The registered manager shared lessons learnt with staff and managed complaints and concerns in an open and honest way.

People told us they felt involved and listened to. They also said staff respected their wishes and preferences.

Staff supported people with meals and drinks and supported to access specialised healthcare when needed.

Overall care visits were prompt. However, some people told us staff were sometimes late with care visits which was a concern for them. People told us they were talking to the registered manager about this.

The registered manager used systems such as training, policies and care plans to ensure that staff had the skills and knowledge to support people who needed end of life care in the future.

The registered manager and the staff team were clear about their roles and the impact of good care.

The registered manager showed ways that they are working with other agencies and providers to share ideas and improve services.

The service met the characteristics of good all areas. For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: The last inspection report was published on 07/04/2016. The service was rated as Good in all five key areas of safe, effective, caring, responsive and well-led. The service received an overall rating of good at the last inspection.

Why we inspected: This was a planned comprehensive inspection based on the date the last inspection report was published.

This inspection took place on the 1 March 2016 and was announced. During our last inspection in November 2013, the service was found to be complying with our regulations.

Rysvil Care Services Ltd is a domiciliary care agency providing personal care to people in their own homes in the Luton area. At the time of our inspection there were 23 people using the service.

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 using the service were kept safe from risk of harm and staff understood the ways in which they could be safeguarded from abuse. Risk assessments were robust and detailed enough to minimise any risk to each person and contained sufficient information to ensure that people’s dietary and healthcare needs were being met where necessary. Satisfaction surveys were sent out to ensure that people were happy with the care they received, and improvements were made on the basis of people’s feedback.

Staff received the correct training to undertake their duties effectively, and received supervisions and performance reviews to support their continued development. Staff understood their roles and responsibilities and were knowledgeable about the ways in which people gave consent and how the Mental Capacity Act was applied in practice. Staff demonstrated a caring attitude and understood how to treat people with dignity and respect. Staff meetings were held regularly and provided an opportunity for the team to meet and discuss issues affecting the service. New staff received a full induction into the service, and robust recruitment procedures were in place to ensure they had the skills and experience necessary for the role.

People’s backgrounds, social histories, preferences and cultural needs were included in their care plans and they were involved in reviews and meetings about issues relating to their care. Where people required support with administration of their medicines, the service kept appropriate records and information on their file. Quality audits were completed regularly to ensure that the service was identifying any areas for improvement and taking appropriate action to resolve them. People and staff were positive about the manager of the service and shared her visions and values. People knew who to complain to if necessary, and the manager had an effective system in place for handling and resolving complaints.

We visited Rysvil Care Services Limited on 11 November 2013, to ensure that the compliance actions which had been made when we visited the service on 02 August 2013 had been achieved. We did not speak to people on this occasion.

We found that improvements had been made to the service’s recruitment procedure. This ensured that the recruitment procedure was effective and people were cared for, or supported by, suitably qualified, skilled and experienced staff.

The complaints process had been reviewed to ensure that the complaints system was effective and complaints were investigated within the agreed timescale and to people's satisfaction.

We spoke with two people who use the service, three relatives, four staff members and the registered manager. People said they were happy with the care provided and that staff respected their privacy and dignity. A person using the service said, “They make sure curtains are drawn. They never make derogatory comments and they are never in a huff or puff. They do what I ask them to do”. Another person said, “They respect my privacy and dignity when providing personal care”.

We found that people’s needs had been assessed to ensure the care they received was safe and effective.

The agency had procedures in place to ensure that people were protected against the risk of acquiring a health care associated infection. There were arrangements in place to ensure equipment used by people was properly maintained.

We found that the agency did not have effective recruitment procedures to ensure appropriate checks were undertaken before staff commenced work.

The agency had a system in place to assess and monitor the care provided to people. We found that the complaints procedure was not effective. Therefore, people could not be assured that their complaints would be responded to appropriately.

We spoke to two people currently using the service. People told us they were happy with the care and support they received from staff. They said their privacy and dignity was respected at all times. One person told us “I have been with several care agencies and this is the best one. It’s brilliant. I have regular carers and I couldn’t ask for a better service.” The two people we spoke with told us that they knew what was in their care plan and everything had been explained to them.

We were told that staff were reliable and professional. One person said “The staff never talk about other people using the service so I feel secure they don’t talk about me to other people.” One person using the service told us they were very happy with the care they received. They said the staff were so helpful and because of this they were able to stay in their home without having to worry.