Our inspection took place on 7 and 8 September and the 6 October 2016. We announced the inspection as the provider is a domiciliary care agency and we needed to be sure someone would be available. This was the locations first inspection under the new methodology. We last inspected this service on 30 January 2014 and found the provider was meeting the standards required.

Sentinel Care Services provides personal care to people living in their own homes. At the time of our inspection the service was supporting seventy seven people.

People were supported by staff who could recognise potential signs of abuse and were confident reporting concerns regarding people’s safety. People were supported by sufficient numbers of staff who had been recruited safely. Risks to the health, safety and well-being of people were identified, managed and regularly reviewed. Staff had a good understanding of how care and support should be provided in order to keep people safe and were able to tell us about people’s individual risks and how to manage them. Accidents and incidents were recorded and investigated and we saw the provider was using this information to ensure risks of re-occurrence were reduced. People received their medicines on time and as prescribed.

People and their relatives told us they mostly received their support calls on time and by consistent staff. Most people and their relatives told us they were informed if for any reason their call was going to be late, however a few people and relatives told us that this was not always the case. The provider had a system to monitor calls and action was taken where calls were late or missed.

People were supported by staff who had sufficient training to meet their needs. People consented to their care and support and people were supported by staff who understood the principles and application of the Mental Capacity Act. However, people’s care records were not written in a way that reflected the decisions that should be made in people’s best interests where they lacked capacity to do so themselves.

People received support with food and drink when required and their dietary and nutritional needs were identified and appropriately managed by the staff team. People had access to healthcare professionals when required and were supported to maintain their health.

People were supported by staff who were caring and treated people with kindness and respect. People and their relatives told us staff developed positive relationships with them. People were involved in making decisions about how their care and support was provided. Staff supported people in a way that maintained their privacy and dignity and promoted their independence.

People and their relatives were involved in the assessment, planning and review of their care and support needs. People were supported by staff who had a good knowledge and understanding of their needs and preferences and were providing care and support in a way that respected them. . People and their relatives knew how to raise a concern or complaint and most people we spoke with told us that concerns and complaints were acted on.

People and their relatives felt the service was well managed and the quality of the care was good. People, relatives and staff told us that the registered manager and the directors were approachable and supportive. Staff felt supported in their roles and understood their responsibilities. There was an open and honest culture within the service and people, relatives and staff were provided with opportunities to provide feedback. The registered manager had systems in place to monitor the quality and consistency of care and the information from these checks was being used to drive improvement.

During this inspection we spoke in private with people who used the service and staff. We also spoke with the managing director, registered manager and operations manager.

People told us that they were very happy with the care staff who supported them. One relative told us, “They monitor my Mum and do a good job”. Other comments included, “I’m 98 now, they’ve grown with me. They’ve accommodated my individual needs as I’ve got more dependant, they are very good carers” and “These girls are lovely they work hard”.

People told us the care staff were flexible and tried to fit in with their wishes. One person told us, “I like to approve my carers, I’ve had a couple of rejections but we’ve dealt with that”. People told us that generally they received care from regular staff who knew their needs well. People told us they had been consulted about their care plans and involved in regular reviews of their care.

We found that care was planned and delivered in line with people's assessed needs and care plans were updated on a regular basis. The provider trained staff in safeguarding vulnerable adults and people told us they felt safe with the care staff. We saw that staff were supervised and their competency was monitored on a regular basis. Staff told us they felt supported in their work.

We found that the provider had systems in place to monitor the quality of the service. This ensured that the service was effective and well led.

We spoke with five people who used the service, five care workers and two members of the management team. People shared very positive experiences of the care and support they received. Comments included, “The staff are really wonderful to us, we couldn’t wish for anything better.” “I’ve never regretted choosing Carewatch, the staff do their job perfectly, I’m very happy indeed.”

People told us they received information about the agency before they agreed to the service. They said their care needs were assessed and they were involved in planning and reviewing their care. People told us staff respected them and maintained their privacy and dignity.

People said they felt comfortable and safe in the presence of the staff. One person commented, “The staff are very trustworthy.” Another person said, “I feel safe with the staff and trust them all.” Staff told us they had received training in safeguarding people and knew the procedure to follow to report any concerns that may arise.

People said they liked the staff. Staff told us the agency had undertaken checks on them to ensure they were safe to work with vulnerable people. We saw the agency had effective recruitment and selection processes in place.

People told us they were ‘very’ satisfied with the service. They said the agency regularly gained their views about quality through satisfaction surveys or spot check visits to their home.