About the service:

The Care Company (SW) Ltd is a service providing care and support to people in their own home. At the time of the inspection the service was providing support to 69 people, but only 47 of those were receiving support with personal care. As the Care Quality Commission (CQC) does not regulate domestic support, this inspection relates only to people receiving the regulated activity of personal care. The service provided both regular daily visits to people in their homes and some live-in staff members, providing a 24-hour support. The service was provided across the rural area of the South Hams in Devon, and in the seaside towns of Torbay.

People’s experience of using this service:

The service was exceptional in placing people at the heart of the service and its values. It had a strong person centred and local community based ethos. Staff and the service’s management told us how important the services’ shared values were to them, and how they were passionate about providing outstanding person-centred care to people when they needed it. Many people being supported told us they thought of their carers as being like family members, and told us they were highly compassionate, caring and flexible. The registered manager told us “We have found in the past if a person feels truly cared for and included and has something to look forward to this has a great impact on their whole wellbeing.”

People’s needs and wishes were met by staff who knew them well. We saw and were told of many examples of staff going ‘above and beyond’ to help and support people they cared for. For example, we were told about how the service had supported a person living with dementia following the loss of their cat. Staff had noticed how depressed the person had become following this loss. The service had taken the person around several local cat shelters before finding the right cat for them to replace their beloved pet. The service told us this action “had a massive effect on the person’s positivity and mental wellbeing.”

Staff were safely recruited, well trained and supported with personalised training programmes and 24 hour back up. The service had a rapid response team to enable them to respond quickly to any care emergencies. Staff were aware of how to report any concerns about neglect or abuse and were confident they would be addressed. They felt they were listened to, and were part of an organisation that cared for them and their wellbeing, as well as the people they were supporting.

People were supported safely, and risks regarding their care were assessed and met. Where this was a part of their care, people’s medicines were administered safely and in accordance with the prescribing instructions. We saw staff also contacted people at times other than during visits to remind them to take certain medicines or to drink fluids.

People and their relatives told us they were treated with great respect for their dignity and privacy. We saw clear evidence of trusting, caring relationships in place, and a clear commitment to support people at difficult times with compassion, respect and affection. We heard, for example, of staff walking miles through recent snowfall to ensure people had hot meals and drinks, and staff supporting people at times of personal bereavement, giving up their own family Christmas to do so.

The service organised many community and individual activities, social events and craft days to help people avoid the risks of social isolation in the rural area where they lived. Efforts were made to ensure people had the same care staff visiting. People’s care and support plans were detailed and followed in practice. The service embraced innovation and learning to improve people’s care experiences, including working alongside other community professionals to provide ‘joined up care’ to people. Some people were being supported by technology through lifeline call systems, and MP3 players with recorded messages and personalised

The Care Company provides care and support to people who live in their own homes in the South Hams and Torbay areas. The services provided include assistance with personal care and domestic work as well as ‘live-in’ carers for those people who require a higher level of care and also companionship.

One of the company directors held the role of registered manager and managed the service on a day to day basis. 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.

This announced inspection took place on 8, 11 and 15 July 2016 and included visits to the office, staff interviews and visits to people in their own homes. At the time of this inspection 83 people were using the service, of which 45 were receiving support with their personal care needs. Domestic help is not regulated by us, and therefore this inspection looked at the care and support of those people who received assistance with their personal care. The service was previously inspected in January 2014 when it was found to be meeting the regulations at that time.

People, their relatives and staff told us the service was well-led. One relative said, “They are unbelievably good. It is a very well run organisation.” The registered manager demonstrated a commitment to continually improve and develop the service. People said they felt safe with the staff when receiving care. They said they had a regular staff team whom they had come to trust and know well. Staff had received training in safeguarding adults and knew how to recognise signs of potential abuse. They understood how to report any concerns in line with the service’s safeguarding policy and said any issues would be dealt with thoroughly. One member of staff said, “our concerns would never be ignored.”

Risks to people’s health and safety had been assessed and regularly reviewed. These assessments included information about how to minimise the chance of harm occurring to people and staff. Staff were provided with step by step instructions about how to help people safely, and in a consistent manner which promoted people’s confidence. One person told us staff needed to use equipment to help them change their position. They said they were confident when the staff used the hoist and said staff always checked the sling to make sure it is safe before they used it. Should an accident occur in a person’s home, the circumstances of the accident were reviewed to identify any actions to reduce the likelihood of a reoccurrence. The service supported some people to take their medicines. Care plans provided information about each person’s medicines and why they were prescribed. People told us the staff supported them safely and they received their medicines as prescribed.

The service employed sufficient numbers of safely recruited and well trained staff to meet people’s needs. Staff told us they had “lots of training” including diabetes, dementia care, care of someone following a stroke as well as health and safety topics. Should a person have very specific care needs, such as the care of a feeding tube, this was undertaken directly with the person and their staff team. One person told us they found the staff, “well trained, competent and excellent in their work”. Staff told us they “loved” their job and felt valued by the registered manager.

People told us they had never had a missed call, and if the staff were going to be late they always received a phone call to notify them. Staff told us they had no concerns over the planning of visits and they were provided with sufficient paid travel time. They said they had enough time to ensure they delivered care safely and visits were not compromised by having to leave early to get to their next perso

With a few notable exceptions everyone we spoke with described the Care Company as being "Wonderful" or "Very very good." One person said "They are not my carers, they are my Ladies. They need gold stars." Even the few people that were less happy qualified their concerns with comments about being grateful or thinking that "In general they are very good."

One person that we spoke with had needed to make a formal complaint and was very satisfied with the manner with which that had been dealt with. They were more than happy with their on-going service. The Care Company looked after some people's medication and personal hygiene needs and we were told that they did this competently and professionally.

On the day of our visit, the service was providing care to 100 people. We spoke with eight people who used the service.

People who used the service and their relatives told us they were very happy with the care they received. They said “I can’t explain the difference it makes to my life, it’s so much easier” and “they’re absolutely brilliant, I’m very happy with the care”. We found the care plans contained enough detail so staff knew how to meet people’s needs.

People who used the service told us they felt safe when staff came into their homes. Staff knew how to report concerns to ensure people were protected from the risk of harm.

We found the agency had a comprehensive staff training programme. People who used the service told us staff knew what to do to meet their needs. Care staff were encouraged to work towards nationally recognised qualifications relevant to their jobs. Staff told us they felt well supported in their job role.

The registered manager was developing the quality assurance systems to ensure the agency was able to assess and monitor the quality of the service. People who used the agency told us they were asked about the quality of the service. People told us that their comments were listened to and acted upon. People told us "I ‘m happy, there’s nothing to complain about"; and "when I’ve asked for any changes, they’ve always accommodated me straight away”.