We undertook an announced inspection of The Caring Company Domiciliary Care Agency (DCA) on 6 June 2017. We told the provider two days before our visit that we would be coming. The Caring Company provides personal care services to people in their own homes. At the time of our inspection 55 people were receiving personal care from the service.

At the previous inspection in August 2016 we found the provider had not taken the necessary steps to mitigate the risks associated with people’s care in that not everyone had appropriate risk assessments in place. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. We also found that the services quality monitoring systems were not always effective. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

At this inspection we found that the service had made improvements to address the areas of concern and bring the service up to the required standards. People’s care records contained up to date and accurate information and guidance for staff to mitigate the risks associated with people’s care. The registered manager conducted regular audits to monitor the quality of service. Learning from these audits was used to make improvements. Records in relation to people who used the service were complete and accurate.

The service had a registered manager. 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 told us they were safe. Staff understood their responsibilities to identify and report all concerns in relation to safeguarding people from abuse. Staff had completed safeguarding training. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

People received their medicines as prescribed. Records confirmed where people needed support with their medicines, they were supported by staff that had been appropriately trained.

People were supported by staff who had the skills and training to carry out their roles and responsibilities. People benefitted from caring relationships with the staff who had a caring approach to their work.

Staff spoke positively about the support they received from the registered manager. Staff had access to effective supervision. Staff and the registered manager shared the visions and values of the service.

The service sought people's views and opinions and acted upon them. People and their relatives told us they were confident they would be listened to and action would be taken if they raised a concern.

People were supported to maintain good health. Various health professionals were involved in assessing, planning and evaluating people's care and treatment.

We undertook an announced inspection of The Caring Company Domiciliary Care Agency (DCA) on 8 August 2016.

The Caring Company provides personal care services to people in their own homes. At the time of our inspection 63 people were receiving a personal care service.

There was a 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.

People told us they were safe. People were supported by staff who could explain how they would recognise and report abuse. People were not protected as people’s care records did not always include up to date risk assessments.

The registered manager informed the CQC of reportable events. The services quality monitoring systems were not always effective.. The service did not always have up to date and accurate records surrounding the day to day management of the service.

Staff we spoke with knew the people they were caring for and supporting, including their preferences and personal histories. Where people needed support with their medication, they were supported by staff who had been appropriately trained. Individual medication administration records were fully completed which showed people received their medicine when needed.

People were supported by staff who had the skills and training to carry out their roles and responsibilities. People benefitted from caring relationships with the staff who had a caring approach to their work. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

The registered manager was knowledgeable about the Mental Capacity Act (MCA) and how to ensure the rights of people who lacked capacity were protected; this included Deprivation of Liberty Safeguards (DoLs). People were supported by staff who understood the principles of MCA. Records showed staff had been trained in the MCA.

Staff spoke positively about the support they received from the registered manager. Staff had access to effective supervision. Staffing rotas indicated there were sufficient staff to meet people’s needs.

People were supported to maintain good health. Various professionals were involved in assessing, planning and evaluating people’s care and treatment.

The provider had a complaints policy in place and we saw evidence that complaints been resolved to the people’s satisfaction and in line with the provider’s complaints policy. Accidents and incidents were recorded and investigated. The registered manager used information from the investigations to improve the service.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report

On the day of our visit there were approximately 95 people using the service. They were supported by 35 care staff. We spoke with the manager who told us that the four office workers were also fully trained care workers who undertook care visits as required.

We spoke with 17 people who were all complimentary about the service. One said "They look after me well. I feel safe and protected". Another said "they really are first class". We spoke with seven care workers. One said "I love this job, it's about people. Their choices, their care".

We saw that people were involved in their care and their dignity and independence was respected. People were involved in initial assessments and the creation of their care plans and we saw they attended health and wellbeing meetings regarding their care. People's care was appropriate to their needs. Care plans were person centred and risks to the person were well managed.

People were protected from abuse. Care workers were regularly trained in safeguarding vulnerable adults and the provider had a robust policy on safeguarding vulnerable adults.

Care workers were supported. We saw that they were appropriately trained and received regular supervisions and annual appraisals. All the care workers we spoke with said they felt supported.

The provider monitored the quality of service people received. Complaints were dealt with appropriately and people's opinions were sought and acted upon. Records were maintained and audits conducted.

People told us they were able to make decisions and choices about their care and support. Prior to receiving a service their care and support needs were assessed.

People, we spoke with confirmed they were involved in their care planning. Comments received included "very good care", "I asked for the care that I wanted at the time I wanted", "I'm always treated with respect and dignity", "carers are always cheerful and pleasant", "excellent service, I have no complaints", "caring, friendly and flexible service provided", "I have recommended the service to friends", " staff are always punctual".

People told us the carers were always reliable and turned up even when it was raining or very cold. Several people told us they particulary liked the schedule of care they receive each week with the name of the member of staff and the times of arrival. They told us that staff always stayed there allocated time.

Staff confirmed they had received training in safeguarding vulnerable adults from abuse. This included the services policies and procedures in the Mental Capacity Act and Deprivation of Liberty Safeguards. There have been no safeguarding concerns since the agency was registered in 2007.

We saw evidence that all had received training in the administration of medication.

We spoke with staff, who told us they had applied to work for the agency following a recommendation from friends.