What life is like for people using this service:

The service was well run and people received good quality support. However, the regulated activity had only been provided since October 2018 and the provider was still in the process of fully implementing some of the systems and processes needed for a domiciliary agency. Areas of improvement were needed. A system for the routine assessment and quality monitoring of the service was needed. Staff felt listened to and well supported but regular staff meetings were not held. A staff member told us they thought it would be good for staff to have regular meetings, and said one had already been planned since the inspection. A complaints procedure was in place and a relative informed us that they would have no concerns about raising a complaint if they needed. They felt confident this would be handled appropriately. However, an accessible version of the complaints procedure was not available to the person supported. Staff had received training in safeguarding adults and understood their role and responsibility to recognise respond and report suspicions or observations of abuse. However, an accessible version of safeguarding information was not available to inform the person of their rights. These are all areas for improvement.

Staff received training to support people with all aspects of their daily lives. New staff completed a period of induction to give them the basic knowledge and skills needed to support the person safely and in accordance with their preferences. All staff received regular updates to their training and were also provided with specialist training such as positive behaviour support, or end of life care. Staff supported the persons health needs and took advice from health professionals around this. Care staff were aware of the persons dietary needs.

The person using the service told us that they were happy. Their relative told us that most staff showed commitment to doing a good job and providing people with good quality support. A health professional told us staff were kind and caring. Our observations showed that the person was treated with respect and their dignity and their confidentiality upheld. Staff knew the person well and adapted their support to meet the persons changing health needs. Staff supported the person to live the life they wanted encouraged independence and supported the person to develop a busy leisure and social life. A communication passport informed and guided staff how to recognise and understand how they communicated their needs and wishes.

The provider had just introduced a new electronic care planning system called ‘Iplanit’ staff used hand held tablets to make live changes to the persons records, the new system also enabled the person and or their relatives with the persons permission to access their records at any time. Records were kept securely with electronic records password protected.

A health professional felt that the registered manager and other staff had been “really great” in responding to the changing needs of the person supported including implementation of 24-hour staff cover. There had been a turnover of staff but the registered manager tried to ensure that only bank staff or agency staff familiar with the service and the persons needs were used to cover shifts. This provided better continuity of support wherever possible. The person’s medicines were managed well. Staff sought consent to care and treatment in line with the Mental Capacity Act 2005 (MCA). Individual and environmental risks were appropriately assessed and measures implemented to keep the person safe. Staff spoke positively about the support they received from the manager and a relative told us that they were happy with the registered managers leadership of the service.

Rating at last inspection: This is the first inspection. Not previously rated

About the service: The Grange (2016) Personal Care is registered as a domiciliary care agency providing the