This inspection took place on the 5 and 15 June 2018 and was announced.

The Home Service [Care Agency] Ltd is a domiciliary care service that provides support to people in West Sussex, including in Midhurst, Petworth and Fernhurst. The service has been providing personal care to people since 2009. At the time of our visit the service provided personal care support to 42 people who were living with a range of care needs. This included support being provided to people living with dementia, physical disability, sensory loss, long term degenerative conditions and long term chronic illness.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission [CQC] 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.

At this inspection we found the evidence continued to support the rating of ‘Good’ overall and there was no evidence or information from our inspection or ongoing monitoring that demonstrated any serious risks or concerns regarding this service. Previously the Caring section of this report was rated as Outstanding. Following the previous report CQC’s methods of inspection have changed and the areas that are now reviewed under the Responsive section. The report format is slightly shorter because the overall rating of the service is ‘Good’ overall.

People, without exception, all spoke very positively about the service they received from this agency and evidence showed that people received a service that met their needs which they were fully involved with. People were ‘matched’ to care staff who knew them well and exceptionally positive relationships were developed between the carers, the people and people’s relatives. We observed that staff who provided care and support were very kind, compassionate, caring and respectful in their approach towards people and their relatives.

People received an exceptionally person-centred service which placed them at the centre of the care and support received. The staff and management team consistently went above and beyond to go ‘the extra mile’ to help and support people in many individual ways. This enabled people to be as independent as possible and to enjoy active participation in community activities. The wider community benefitted from the kindness of the registered manager with a donation of equipment that enabled people to bird (and squirrel) watch when they may have been unwell while staying in a local hospital. People told us that the support they received from the agency made a real difference to their everyday lives, with one person telling us that the agency had “saved” their life and enabled them to take pleasure in their lives again with strong relationships being developed between the dedicated staff team, people and their relatives. Relationships with external professionals were also very positive and people were supported by the agency to attend medical appointments and to access healthcare professional support when they needed it.

Care staff were well-trained and very well supported with evidence seen of regular supervisions, observations and ‘spot checks’ that took place to monitor that high standards of care were maintained for people.

Systems and processes, including safe recruitment practices ensured that people were safeguarded from abuse. People received their medicines safely. Care staff were aware of and practiced safe infection control, using the protective equipment that was provided to them appropriately. Staff understood how to support people with behaviours that may challenge at times and did this sensitively with support from the registered manager.

The service provided to people by this agency was extremely person-centred and driven by a passionate team of dedicated care and management staf

The inspection took place on 18 and 20 January 2016 and was announced.

The Home Service (Care Agency) Ltd is a domiciliary care service that provides support to people in West Sussex, including in Midhurst, Petworth and Fernhurst. The service has been providing personal care to people since 2009. At the time of our visit the service was supporting 26 people with personal care.

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, their representatives and staff spoke enthusiastically about the service and the friendships they had developed. One person told us, “They’re (the staff) kindly and considerate”. Another said, “They’re always cheerful and never moaning”. A relative had written in a feedback questionnaire, ‘My wife likes to be woken to a little light humour in the morning and most of your staff certainly provide it!”

People and/or their representatives were fully involved in planning the care that they received and were extremely positive about the service. As staff got to know people better and understood more about their preferences, the care plans were updated. The registered manager told us, “Usually the initial care plan will change fairly quickly once we start working”. There was a minimum visit time of half an hour and people were encouraged to participate in their care and to maintain their independence. Staff encouraged get out into the community. Many people spoke enthusiastically about the provider’s Christmas party and how much they had enjoyed it. The registered manager explained how they were planning to build on this idea and hold regular coffee mornings as social events but also to build people’s confidence to attend other events in the community. Many people shared stories of how staff had supported them and had gone above and beyond what they expected them to do.

People received a safe service. Staff understood local safeguarding procedures. Risks to people’s safety were assessed and reviewed. The service was also proactive in making referrals, such as to the Fire and Rescue Service where there was the opportunity to enhance the safety of the home environment. The service had contingency plans in place to deal with emergencies such as a failure of equipment or severe weather. There were enough staff employed and the rotas were managed effectively so that people received a reliable service. People received their medicines safely and at the right time though we discussed with the registered manager how the level of support people required could be made clearer in the records.

People had confidence in the staff who supported them. One said, “They’re very competent”. Staff received training to enable them to deliver effective care. They were supported in their roles and professional development by a system of supervision. Staff understood how consent should be considered in line with the Mental Capacity Act 2005. Staff supported people to prepare meals and to eat and drink if required. Where people could benefit from additional support, referrals were made to other healthcare professionals such as the GP or District Nurses.

People felt able to contact the registered manager if they had concerns and said that they received a quick response. People told us that they understood how to complain but had not needed to. No written complaints had been received by the service.

The registered manager monitored the quality of the service by maintaining regular contact with people and staff. There was also a system of spot checks in place and daily records of the care delivered to people were reviewed monthly. This helped to ensure that the service delivered was of a consistently hi