This inspection was announced and took place on 7 September 2016. We gave the provider 48 hours’ notice of our intention to undertake the inspection. This was because the service provides domiciliary care to people in their own homes and we needed to make sure someone would be available at the office.

The Garth Care Services (Home Care) is a domiciliary care agency registered to provide personal care to people living in their own homes. At the time of our inspection 17 people received care and support services.

Prior to the inspection the registered manager had left the service and a new manager had been appointed and was in the process of registering with the Care Quality Commission (CQC). 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 that they felt safe when staff entered their home and that staff knew how to support them. Staff were able to tell us of the needs of the people they provided care for and their roles and responsibilities in keeping people safe.

There were sufficient numbers of staff, who had a good understanding of protecting people from the risk of abuse and harm and their responsibilities to report suspected abuse. Medicines were administered by staff that had received training to do this. The provider had procedures in place to check that people received their medicines as prescribed to effectively and safely meet their health needs.

People told us they received reliable care from a regular team of trained staff who understood their likes, dislikes and preferences for care and support and that they were kept informed of any changes. Staff sought people’s consent and demonstrated their understanding of people’s right to refuse care.

Staff supported people to make their own choices and decision’s about their care and support. We found people were involved in how their care was planned and their needs met. Staff supported people to access health care services such as their GP or district nurses.

People told us they had developed good relationships with staff and they were treated with dignity and respect. People received care that met their individual needs. People and staff said managers listened to them and they felt confident they could raise any issues should the need arise.

The manager ensured regular checks were completed to monitor the quality of the care that people received and action had been taken where areas were identified for improvement. People and staff spoke positively about the manager and the support they provided.

People were positive about the care and support they received and the service as a whole.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us the care they received was very good. They told us they felt safe when the care workers were in their home. One relative told us that, "I feel very happy that the Garth staff are caring for my relative. I know they will be treated well and kept safe".

There were appropriate policies and procedures relating to consent. Staff had received training and were clear about their responsibilities. People who received a service told us staff always asked consent before they did anything.

The home had appropriate policies and procedures in relation to the Mental Capacity Act. Staff were clear about their role and responsibilities.

Systems were in place to ensure that learning took place from incidents, complaints and audits. Risk assessments were robust and reviewed regularly. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

Care plans were kept up to date and contained relevant information to ensure people's safety and welfare. Staff told us that the care plans provided them with sufficient information to deliver people’s care.

People were fully involved in developing their care plans. Risk assessments were completed for each person. Actions to reduce the risks identified were clearly reflected in care plans.

Information and guidance was available to staff to support them in delivering care. Staff had access to care coordinators and the manager for advice and support.

Staff had received training relevant to their role and the needs of the people they cared for.

Is the service caring?

People told us that the staff were kind and compassionate and treated them with dignity and respect. One person told us, "I call them (the care workers) the Garth Angels". We saw that care records recorded people’s likes, preferences and dislikes. The daily records completed by the care staff demonstrated how staff ensured care was delivered as people wished.

People’s comments, recorded in annual survey’s and care plan reviews, were very positive about the care they received.

Is the service responsive?

People told us that the issues they raised and suggestions they made were acted upon. People knew how to make a complaint if they needed to. We looked at how complaints were managed, and found that complaints were investigated fully and action taken as necessary.

An annual survey was undertaken and people’s views on the service were sought at each care review. A range of audits had been undertaken. Action plans were in place to address the issues raised. Actions were discussed and monitored at staff meetings.

Is the service well-led?

Staff told us that they felt supported by their manager. They told us that their registered? manager listened to their views and was always fair. An annual staff survey and staff meetings gave staff the opportunity to raise issues. Staff demonstrated they were clear about their role and responsibilities.

There were systems and processes in place to monitor the quality of the service. This included satisfaction surveys, audits and supervision visits to observe the care delivered.

Systems were in place to ensure that learning took place from incidents, complaints and audits. Risk assessments were robust and reviewed regularly. This reduced the risks to people and helped the service to continually improve.

The people we spoke with told us that the service was good. They said the staff treated them with respect. People said, "We know who is coming and are never left waiting for them to arrive" and “The girls are all very pleasant.”

People told us they were regularly asked if their service was satisfactory. They told us that the senior staff assessed their needs. In the care plans we looked at we saw the instructions for staff minimised risks to people’s health and well-being. One person told us, “They stick to the agreement.”

Staff told us they had training in safeguarding people from abuse.

Staff also told us they felt supported to work effectively.

The provider had systems in place that enabled them to identify problems swiftly and act upon them to keep people safe at all times. This meant that the service was managed well.

People who used the service said that they were well looked after. They told us that the staff always asked them how they would like things to be done, always respected their privacy and treated them with respect. They said staff talked to them about how they liked their support to be provided.

People told us that they felt able to raise any issues with the manager or staff should they have any concerns. Staff talked of their awareness of how to keep people safe from harm. Staff told us about the training that the service had arranged for them so that they would recognise abuse and how to report it.

People told us that staff were punctual and reliable. People’s relatives told us that staff were always friendly and professional when they visited. One person said “I’ve seen them. Very good with ***” and another said “The staff are very caring”.

People we spoke with said their comments were listened to. A relative said that they would not hesitate to talk to staff if something was wrong.

We spoke with three people who use the service. Everyone was happy with the standard of care given and felt that they were included in decisions around their care. One person said “I look forward to seeing them”. Another said that the staff were “extremely good, I can’t fault them”. People said that they had not had any missed calls, and had always been informed of any change of carer by telephone or in person.