About the service:

Tapestry provides care and support to people who live in their own homes. At the time of our visit, they were providing personal care to 23 people.

People’s experience of using this service:

¿People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

¿Staff had attended appropriate training. Regular supervision including spot checks and annual appraisals were completed to ensure that staff were supported to deliver safe care to people using the service.

¿There were sufficient numbers of staff to meet people’s needs and safe recruitment practices were in place.

¿There were systems in place to make sure people received their medicines safely. People were supported with their nutritional and hydration needs.

¿People received care and support which was personalised to their wishes and responsive to their needs. Before a person started to use the service, an assessment of their abilities and needs was undertaken. Risk assessments were in place to ensure people’s safety. Regular reviews of people’s care took place.

¿People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

¿People's preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with their wishes. Staff encouraged people’s independence when providing care and support to them. People were supported with a wide variety of their preferred social activities and interests.

¿People and relatives felt the service was run well. Staff also felt supported by the manager. They had a good understanding of the ethos of the service and demonstrated a clear understanding of what was expected of them.

¿There was a range of effective audit and quality assurance procedures in place. These were used as a means of identifying areas for improvement and where good practice had been established. The provider took account of complaints and comments to improve the service.

Rating at last inspection:

Good (report published 22 September 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

For more details, please see the full report which is on CQC website at www.cqc.org.uk.

This was an announced inspection carried out on 22 September 2016. The manager was given 48 hours' notice because the service provides a domiciliary care service and we needed to be sure that someone would be in. The service was previously inspected on 4 February 2014, when no breaches of legal requirements were identified.

Tapestry provides care and support to people who live in their own homes. At the time of our inspection there were 27 people receiving personal care from the service.

The service had no 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. The manager was in the process of registering with the Care Quality Commission.

People told us they felt safe using the service. There were systems in place to protect people from the risk of harm. Staff knew how to identify abuse and where they should report their concerns to.

We saw accidents and incidents were recorded and monitored to identify how the risks of reoccurrence could be reduced. Risk assessments were centred on the needs of people and included guidance to staff on how to reduce identified risks.

There was a recruitment system in place that helped the provider make safer recruitment decisions when employing new staff. Staff received a structured induction at the beginning of their employment. They felt well supported by the management of the service and received regular supervision and annual appraisal. They also received on-going training.

The service employed enough staff to meet the needs of people. Staff knew people well and understood how to meet their support needs. People’s needs had been assessed before they started using the service. People or their representatives had been involved in writing their care plans.

The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves.

Staff were trained in the safe administration of medicines and kept relevant records that were accurate. Medicines were administered safely.

The provider had a complaints procedure and we saw correct procedure had been used to investigate and resolve issues when concerns had been raised.

The manager worked closely with other health professionals to ensure the needs of people were fully met. People were referred to health care professionals when needed.

People were treated with kindness and respect. Staff promoted people’s independence and their privacy was respected.

People were supported to prepare meals that met their needs and choices. Staff knew people’s dietary preferences.

The manager was clear about their responsibilities and accountabilities. There was an open culture that put people at the centre of their care and support. People, relatives and staff spoke positively about the service and the way it was run.

People’s views and opinions were sought and listened to. Feedback from people receiving support was used to drive improvements.

We found that people and their relatives were involved in discussions about their care and support and how it was delivered by care workers. They told us that they were treated with respect and their consent was sought before any care was delivered. People's needs were assessed. Their care and support was planned and delivered in line with their individual care plan which outlined their individual needs. It included their personal care tasks, risk assessments and well being. One person told us “they always listen to me, we have a good chat.” A relative said "we were involved initially for the assessment and the care plan and they follow it. She (mum) is quite happy with the carers and we are well pleased."

Staff were appropriately supported by the manager or care co-ordinator to deliver care and support to people safely and to an appropriate standard by providing supervision, appraisal and appropriate training. People who used the service and their representatives were asked for their views about the care and support provided by the service. We found that records were easily accessible, up to date and were stored securely.