The inspection took place on 07 October 2016, and was an announced inspection. The registered provider was given 48 hours' notice of the inspection. At the previous inspection on 18 February 2014 no breaches were found.

Sentinel Care is a very small service in the South East that provides live in carers only, supporting adults in their own homes. The service provides support for people living with dementia, physical disabilities and terminal illness.

At the time of this inspection there were 4 people receiving support with their personal care. The service provided one to one support hours to people, for 24 hours a day, over either a two or four week period.

The service is managed by the registered provider. Registered providers 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 and relatives were involved in the initial assessment and the planning of their support. Care plans contained details of people's wishes and preferences, and were regularly reviewed to ensure they contained up to date information.

Risks associated with people's support had been identified and clear guidance was in place to keep people safe.

People had their needs met by sufficient numbers of live in carers. People received a service from a very small and consistent team of live in carers, who were recruited to match the people they supported. New live in carers underwent an induction programme, which included relevant training courses and shadowing experienced staff, until they were competent to work on their own.

Live in carers received training appropriate to their role, which was refreshed regularly to ensure staffs knowledge remained up to date. The registered provider had supported all live in carers to gain qualifications in health and social care.

People were supported to maintain good health and attend appointments and check-ups. People's medicines were handled in line with the registered providers policy and procedures.

People and relatives felt they were treated with dignity and respect and that the live in carers were kind and caring.

People and relatives felt people were safe using the service. The service had safeguarding procedures in place and all live in carers had received training in these.

People had opportunities to provide feedback about the service provided. Systems were in place to ensure the service ran effectively and people received a quality service.

The registered provider completed checks to ensure that the service operated in an efficient and effective manner, ensuring that people were appropriately supported. There was a business plan in place with aims and objectives and live in carers followed this through in their practice.

Sentinel Care introduced self-employed care workers who stayed with a person who used the service in their own home for 24 hours per day for a two week period. We visited the office and spoke with the provider. We later spoke by telephone with one person who used the service, one relative and one live in carer.

People spoke very positively about the service. One person said, "It’s a smooth run operation". People said that the staff respected their privacy and dignity whilst in their homes and encouraged their independence.

People were involved and discussed their care and support to ensure it was delivered as they wanted. Care and support was provided by a very small team of live in carers.

People felt that the service introduced live in carers of the right calibre to meet their needs.

People told us that if they had any concerns they would speak with the provider. People said the provider visited weekly in order to check the service was running smoothly and resolve any issues. One person said, "Carol (the provider) was here yesterday checking everything was OK".

Sentinel Care was a very small introduction agency providing care and support to people. They introduced self-employed care workers who stayed with a person who used the service in their own home for 24 hours per day for a three to four week period. We spoke with one person who used the service, a relative, the provider and two staff.

People spoke very positively about the service. One person said, “It’s excellent”. People said that the staff respected their privacy and dignity whilst in their homes and encouraged their independence. One person said, “I am especially pleased right now, I have a very good carer”.

People were aware of their care plan and had their own copy. They confirmed that they and sometimes their family had been involved in discussions about their care, when the service had first started.

People felt that the service introduced staff of the right calibre to meet their needs.

People told us that if they had any concerns they would speak with the provider. People said the provider visited weekly in order to check the service was running smoothly and resolve any issues. One person said, “They go over and beyond the call of duty”.