The inspection was announced and took place on 20 August 2015. The provider had short notice that an inspection would take place. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to ensure that the registered manager would be available to assist us. At the last inspection in September 2013, we found the provider was meeting all of the requirements of the regulations we reviewed.

The Care Bureau provides care and support to people living in their own homes. At the time of the inspection 113 people were receiving a personal care service.

There was a registered manager in post at the time of the inspection. 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 we spoke with told us they felt safe using the service and said they were looked after well.

Staff had received training in how to recognise and report potential abuse and were confident in raising concerns directly with the registered manager. People were supported by enough staff to meet their individual needs and to provide them with a flexible service most of the time. Most people told us they were introduced to their care workers before they provided any care or support.

People were supported by staff that had the skills and knowledge to meet their individual needs. Staff were knowledgeable about the people they cared for and knew how to recognise if people’s needs changed. They were kind and compassionate and treated people with dignity and respect and knew how to promote people’s rights, choices and independence. There were systems in place to make sure that the human rights of people who may lack mental capacity to make decisions were protected.

Most people felt their care and support was planned and reviewed in partnership with them and significant others involved in their care. People’s needs had been assessed before their care package commenced. Most people seemed very happy with the care they received, although there were some reservations about younger, less experienced carers. Care plans detailed people’s assessed needs and preferences and provided staff with guidance about how people preferred their needs to be met.

Not everyone was aware of the formal complaints procedure but were confident that they could contact the office with any complaint and felt they would be listened to.

The provider had systems in place to enable people to share their opinion of the service provided and to monitor the quality of service. People found their care workers and the management team approachable and found they promoted a positive culture.

People shared positive experiences about their care and the service they received. They told us, "They're brilliant, I couldn’t do without them” and, "The care is excellent". People told us they liked the staff, and they were always treated in a respectful and dignified manner.

The manager demonstrated a very good knowledge of people's individual needs. They showed a genuine compassion for each person. Care plans were detailed and gave staff the information they needed. We saw the agency was responsive to changes in people's needs.

Appropriate checks were carried out to ensure staff were safe to work with vulnerable people.

Staff received a range of training to give them the skills and knowledge they required to keep people safe and to meet their individual needs. Care workers told us they were well supported in their work.

There were effective systems in place to monitor the quality of the service and to gain people’s views to drive improvement.

We spoke with two people who used the service, six staff and two people’s representatives. Everyone we spoke with had very positive experiences of the care and support they or their relative received. Comments included, “I’ve been very impressed with the service received so far.” “We’re very happy and can’t fault them.”

People said their care needs were assessed and they were involved in planning their care. They told us staff respected them and maintained their privacy and dignity.

People said they felt comfortable and safe in staff presence. One person commented, “I feel very safe with them.” Staff told us they had received mandatory training in keeping people safe. They knew the procedure to follow to report any concerns that may arise.

People told us they liked the staff and considered they were skilled in their work. Not all staff had received training to understand the specific health conditions of the people they supported. People said their care workers usually arrived on time and stayed for the time allocated. One person said, “The staff we get are really good, nice and helpful.” Another said, “Some seem more knowledgeable than others.”

People said they were satisfied with the service. They told us the agency gained their views about quality through telephone discussions, satisfaction surveys or spot check visits to their home. We saw a thank you card stating, “We couldn't have asked for better people to help us look after our mom.”