We inspected this service on 17 and 18 September 2018. The inspection was unannounced. At the last inspection, in April 2016, the service was rated ‘Good.’ At this inspection we have rated the service as ‘Good.’

Thyme Care, provides people with personal care in their own homes. At the time of the inspection the service provided support for approximately 68 people for people in the Penzance and St Ives areas. The service works primarily with elderly people.

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.

The service had satisfactory safeguarding policies and procedures to keep people safe. Staff were trained to recognise abuse, and knew what to do if they suspected abuse was occurring. Suitable risk assessment procedures were in place, and risk assessments were regularly reviewed. Where appropriate management and staff had submitted safeguarding referrals to the local authority.

Recruitment checks for new staff were satisfactory. For example, the registered provider obtained a Disclosure and Barring Service check and written reference check when the member of staff was recruited. When staff started to work at the agency they were required to complete a staff induction programme, which included relevant training which assisted the member of staff to carry out their job. The registered provider had a suitable system of staff supervision and annual appraisal.

Medicines procedures were safe, and we saw evidence that supported this, including administration records and systems to support people with medicines. Staff were trained in procedures to minimise the risk of infection. People and their relatives said staff were always well presented in their individual roles.. Staff said they were provided with disposable gloves and aprons to support them in their roles.

There were satisfactory procedures to assess people to check they were suitable to receive support from the service. Subsequently staff developed comprehensive care plans for people and these were regularly reviewed.

Some people received support to prepare meals. Where necessary procedures to monitor the food people had eaten and their fluid intake, were satisfactory.

Where people lacked mental capacity, the agency provided people with the correct support to ensure their rights were protected.

Staff worked with people to maximise their independence. We received positive support about staff attitudes. Comments included; “I have tremendous confidence in them,” “Very nice people…they are marvellous,” “I cannot fault them. They are as good as gold. They will do anything for me,” and “They have been very good. Very helpful.” A relative said, “They are very caring…It is not put on.”

The service had a complaints procedure. People said they would approach staff or management if they had a concern. People told us where they had raised concerns or complaints these had been managed sensitively and resolved appropriately.

Management were viewed positively by the people who used the service and staff who we contacted.

The staff team told us they worked well together. People and their relatives viewed staff positively and staff were viewed as caring.

Quality assurance processes were satisfactory to monitor the service was working effectively, and pick up and address shortfalls in service provision.

Thyme Care provides personal care to people who live in their own homes in the Penzance, St Ives and Hayle areas of Cornwall. At the time of our inspection the team of 23 care staff was providing support to approximately 73 predominantly elderly people.

The service is required to have a registered manager and at the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

People told us they felt safe and were well cared for by Thyme Care. Their comments included; ““I do feel safe,” and “They (care staff) are so caring and kind, they look after me very well.” People’s relatives echoed this and said, “I am reassured that my father is receiving care from carers who really do care. If they thought dad wasn’t safe they would let me know.” Another commented, “My dad trusts (carer staff’s name) in particular. This gives me reassurance as I know he is being cared for by staff who care.”

People told us they had “never” experienced a missed care visit. The management team told us “Missed visits are not an option. People in the community are vulnerable and we must and do visit when we say we will.” The service had robust and effective procedures in place to ensure that all planned care visits were provided.

People told us that their visits were on time but there were ‘rare occasions’ when care staff could be late for their planned visits. However people, and relatives, did not have a concern regarding this as they understood that care staff lateness were due to needing to provide extra support to a person in an emergency or travel issues, especially in holiday seasons. People told us that Thyme Care headquarters would “usually” phone them if a care worker was going to be late which gave them reassurance that their visit would still continue. We found staff consistently provided the care visits of the correct visit length. People told us their staff never rushed them and staff stayed for the correct duration of their visit.

The registered manager was confident about the action to take if they had any safeguarding concerns and had liaised with the safeguarding teams as appropriate. Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence.

People said staff were well trained and understood how to meet their specific care needs. Training records showed staff had been provided with all the necessary training which had been refreshed regularly. Staff told us they had ‘lots of training” and found the training to be beneficial to their role.

The service’s systems for the induction of new members of staff were effective and fully complied with the requirements of the Care Certificate. Training was provided in accordance with the 15 fundamental standards. The service had commissioned a training academy to provide the induction and further training courses to their staff team. Staff said they were encouraged to attend training to develop their skills, and their career.

Staff received regular supervisions and annual performance appraisals. In addition ‘spot checks’ by managers were used regularly to confirm each member of staff was providing appropriate standards of care and support.

People were supported by stable and consistent staff teams who knew people well and had received training specific to their needs. People told us they were introduced to new staff before they supported them in their home. People confirmed they had consistent carers to support them and had built up positive relationships with staff.

Thyme care identified that some people only saw

We spoke with 11 people who used the service and/or their relatives by telephone during the inspection. All of the people we spoke with were complementary of the care they received from Thyme Care Limited. Comments included “always been first class”, “I am very very happy, don’t change them” and the staff are “absolutely delightful, they really are”.

People’s privacy, dignity and independence were respected and care was planned and delivered in a way that was intended to ensure people's safety and welfare.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people received.