Saxon Care Solutions Limited provides a care at home service for adults in Chippenham and the surrounding areas. At the time of our inspection 118 people were receiving personal care from the service.

The service was last inspected in November 2013 and was found to be meeting all of the standards assessed.

This inspection took place on 15 December 2016. This was an announced inspection which meant the provider was given notice before we visited. This was because the location provides a home care service. We wanted to make sure the registered manager, or someone who could act on their behalf, would be available to support our inspection.

There was a registered manager in post at the service. 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 and associated Regulations about how the service is run.

Systems to support people with their medicines were not always clear. It was not always recorded what action was needed to support people with medicines that were prescribed to be taken ‘as required’. The registered manager acknowledged this shortfall and said immediate action would be taken to clarify issues in the care plan. Despite the lack of clear information in the care plan, staff had worked with the person’s relatives and had received specific training about the person’s needs and how to administer their medicines.

People who use the service and their relatives were positive about the care they received and praised the quality of the staff and management. Comments from people included, “I feel very safe in their hands. They know exactly what they are doing”, “I think they are very well trained, they all do a very good job” and “They are all very good, very capable”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.

Staff understood the needs of the people they were providing care for. Staff were appropriately trained and skilled. They received a thorough induction when they started working for the service and demonstrated a good understanding of their role and responsibilities. Staff had completed training to ensure the care and support provided to people was safe and effective to meet their needs. Comments from staff included, “They’re very accommodating and work around any issues. We are not expected to do things we’re not confident about”, “We are able to raise concerns at any time and they will drop everything. I feel 100% supported” and “I feel well supported. We are able to raise any concerns and I am clear about the values of the company”.

The service was responsive to people’s needs and wishes. People had regular meetings to provide feedback about their care and there was an effective complaints procedure. People and their relatives felt they could contact the office if needed and they also had contact numbers out of office hours, in case of an emergency.

The provider regularly assessed and monitored the quality of the service provided. Feedback from people and their relatives was encouraged and was used to make improvements to the service.

When we inspected Saxon Care Solutions in May 2013 we found that outcomes for people who used the service were met in relation to them giving consent, their care and welfare, the management of their medicines, complaints processes, and recruitment of staff to support them. We found the agency had a sound statement of its purpose.

We carried out this further inspection because we received concerns expressed by an ex-member of staff. Their concerns related to care and welfare, safeguarding arrangements and staffing. We also looked at the way complaints were handled because the agency had received a complaint from an ex-member of staff.

As part of this inspection we contacted the relative of one of the people who used the service. They told us they continued to be happy with the care provided by the agency care staff. They said that care staff involved them when providing personal assistance ensuring they knew about the healing of a pressure area. The relative told us they knew everything that was happening in relation to the care provided.

We spoke with one of the care staff when they visited the agency. They said they enjoyed their work and were familiar with the agency’s policies.

This report should be read alongside the report we published in June 2013.

We spoke with the manager and three office staff. They were all cheerful in their work and happy to be working for Saxon Care Solutions. They spoke about good relationships with each other and care staff. They talked about team working and we saw them supporting each other with tasks. We also spoke with three care staff.

We spoke with six people who received a service and one person’s relative. Some people said they received information about the support available from the agency while others said they had not and their care had been arranged by health and social professionals or they had transferred from another service.

People said the support they received enabled them to remain as independent as possible and that support met their needs. They did have concerns about late calls. Each person we spoke with felt that staff treated them with respect and they gave consent to the support they received. People told us they were supported with medicines and we saw evidence of recording of this. One person felt that sometimes, the office staff were not supportive and another person criticised the availability of the office staff at times.

Staff were recruited as required. The process for gaining employment with the agency was rigorous with appropriate checks carried out to ensure that staff were appropriate.

People we spoke with knew how to make a complaint.

Saxon Care Solutions is a small domiciliary care agency, first registered with the Care Quality Commission in March 2011.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an “expert by experience”, people who have experience of using services and who can provide that perspective and a professional advisor.”

We used telephone interviews and home visits to people who use the service and to their main carers (a relative or friends) to gain views about the service. We also spent time with the provider, the manager and office staff.

People reported that they got the help that they needed and expected to receive. They were happy with the service they received but did make comments that care staff travelling time (in between different people they were supporting), affected the timing of their visits. People did not report that this impacted upon the care they received. Comments we received included “the carers treat me very nicely and are always very polite”, “I am treated with the utmost courtesy” and “if I was at all unhappy about the service I was receiving I would speak out. I have experienced poor support from other agencies but you can not fault Saxon Care”.

Care staff spoke respectfully about the people they supported, and talked of the importance of confidentiality and dignity in care. Care staff spoke about how they supported the families of people receiving a service, as well.