This inspection took place between 17 and 20 December 2018.

Town and Country Care (Whitby) Ltd is a domiciliary care agency. It provides personal care to people living in their own homes to predominantly older people. At the last inspection the service was rated ‘good’. At this inspection we found the evidence continued to support the rating of ‘good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the time of inspecting 80 people were receiving a regulated activity. Not everyone using the service receives a regulated activity; CQC only inspects the service being provided by people with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

A registered manager was 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.

Safe understood and followed safeguarding procedures to protect people from harm. Where risks to people were identified, appropriate plans to manage these were in place.

Medicine had been administered safely. Staff had received medicines training and regularly had their competencies in this area assessed. People told us staff followed good infection control practices and the provider ensured personal protective equipment was readily available.

New staff received a thorough induction to the service and were supported with regular one to one supervisions and observations. A thorough training program was in place.

People were supported, where needed, to maintain good food and fluid intake. Care records clearly detailed the level of supported people required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Consent to care and treatment was recorded and staff respected people’s choices.

People told us they were actively involved in the planning of their care. Care records contained person-centred information. Regular care reviews had taken place to ensure the support in place continued to meet their needs. People were encouraged to engage with others to avoid social isolation.

People told us staff were kind and caring and treated them with dignity and respected. Staff were knowledgeable about peoples likes, dislikes and preferences and positive relationships had been developed. Care records showed that people were encouraged to remain as independent as possible. Staff provided advise on where aids to maintain independence could be sourced.

The management team were friendly, approachable and responsive. People were asked to provide regular feedback on the service provided. Quality audits had been conducted to monitor and improve the service although these were not always consistently recorded.

The registered manager was continuously trying to develop the service through the introduction of electronic systems and initiatives to retain staff. Staff told us they were well supported and valued by management.

Further information is in the detailed findings below.

This inspection took place on the 20 May 2016 and was announced.

Town and Country Care (Whitby) Ltd. provides care and support to people who live in their own homes within the Whitby and district area.

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 using the service told us they felt safe while staff were supporting them with personal care. Staff told us they were confident that if they had any concerns about people's safety, health or welfare then they would know what action to take, which would include reporting their concerns to the registered manager or to relevant external agencies.

Potential risks to people were assessed and used to develop plans of care to protect them from harm while maximising their freedom.

Staff had undergone a robust recruitment process and received training and supervision to enable them to meet people's needs in a safe and timely way.

People's needs were met, which included support with meals and drinks when required.

Staff liaised with health care services and external agencies where appropriate.

People's choices and decisions were recorded in their care records. Staff gained consent from people before delivering care. Staff promoted the rights and decisions of people and were aware of the principles of the Mental Capacity Act 2005.

People's needs had been assessed prior to them receiving a service and they told us they had been involved in the development and reviewing of their care plans.

People were very happy with the care and support they received. People made positive comments about staff and told us they were kind and helpful.

We saw appropriate information was given to people using the service to ensure they knew how to raise concerns, or make a complaint. People also told us they were aware of how to raise concerns. Complaints had been addressed and actions had been recorded.

The service responded to people’s individual needs and preferences and care plans reflected the knowledge staff had of each person, so that they could be placed in the centre of care.

Staff were organised into specialist teams which meant that people most often received care from staff they were familiar with and who knew their needs well.

Systems were in place to check the quality of the service provided. The registered manager sought regular feedback from people in order to develop and improve the service.

Regular staff meetings were held where staff were encouraged to voice their views. They told us that communication was effective and that they felt supported by the registered manager.

We spoke with ten people who used the service. People were all satisfied with the care and support they received. One person told us. "They work alongside us and listen to what we say." Another person told us "They are excellent, very caring and reliable."

We found that the service obtained people's consent before offering care and support. Staff understood that people should be enabled to make decisions about their care.

People's care needs were assessed and care plans were drawn up to meet those needs. Risks were assessed and strategies were in place to minimise these. Risk assessments and care plans were kept under regular review. Specialists were consulted so that people had the benefit of expert advice.

There were sufficient staff on duty to meet people's needs, and the mix of experience and skills was taken into consideration to ensure people's needs could be met safely.

The service handled medication safely.

The service had a system in place to assess and monitor the quality of care and support so that it could plan required improvements.