We carried out an announced inspection of Townfield Home Care on 25 and 26 July 2018.

This service is a domiciliary care agency. It provides personal care to people living in their own houses. At the time of the inspection, 150 people were receiving a service from the agency with a range of health and social care needs, such as people with a physical disability and people living with dementia. Support was tailored according to people's assessed needs within the context of people's individual preferences and lifestyles to help people to live and maintain independent lives and remain in their homes.

At the last inspection, in February 2016 the service was rated overall as ‘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.

Staff knew how to recognise and report abuse and understood their responsibilities in keeping people safe. Where risks to people's safety had been identified, ways to mitigate these risks had been discussed with the person and recorded so staff knew how to support the person safely. The provider was following appropriate recruitment procedures to make sure only suitable staff were employed. People received their medicines when they needed them from staff who had been trained and had their competency checked. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others.

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. Staff were provided with the training they required in order to support people safely and effectively. An induction and training programme was in place for all staff. A detailed assessment was carried out to assess people’s needs and preferences prior to them receiving a service. This meant that care outcomes were planned and staff understood what support each person required. People were supported with their healthcare and nutritional needs as appropriate.

Care and support was planned and personalised to each person, which ensured they were able to make choices about their daily lives. People had access to a complaints procedure. Where people received end of life care this was planned and provided sensitively.

Quality assurance and information governance systems remained in place to monitor the quality and safety of the service. People and relatives spoken with told us that they were satisfied with the service provided and the way it was managed.

We carried out an inspection of Townfield Home Care on 9 and 10 February 2016. We gave the service 48 hours’ notice of our intention to carry out the inspection.

Townfield Home Care is registered to provide personal care to people living in their own homes. The agency’s office is located in near the centre of Great Harwood, close to all local amenities. The agency provides a service to people residing in Hyndburn, Ribble Valley and Rossendale. At the time of the inspection 102 people were using the service.

The service was managed by 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.

We lasted inspected this service on 7 January 2014 and found it was meeting all legal requirements.

During this inspection we found the service was meeting the current regulations.

People and their relatives were happy with the service they received from Townfield Home Care. They told us they felt safe using the service. Potential risks to people’s health and well-being were assessed and managed effectively. Staff showed awareness of how to keep people safe and understood the policies and procedures used to safeguard people. Staff were also aware of the procedures to follow to ensure medicines were handled safely.

Safe recruitment practices were followed and appropriate checks were undertaken, which helped to ensure suitable staff were employed to care for people. There were sufficient numbers of staff to maintain the schedule of care visits. Staff told us they felt supported and received regular supervision and support from the management team.

All staff spoken with had an awareness of the Mental Capacity Act 2005 and had completed appropriate training. People had signed a consent form to indicate their agreement for care to be provided in line with their care plan.

Where appropriate, people were supported to have a balanced diet that promoted healthy eating.

Staff were respectful of people’s privacy and maintained their dignity. All people spoken with told us the staff were kind and caring.

Care records and risk assessments were person-centred and were an accurate reflection of the person’s care and support needs. The care plans were written with the person, so they were able to influence the delivery of their care. The care plans included the person’s likes and preferences and were reviewed regularly to reflect changes to the person’s needs and circumstances. This meant staff had up to date information about people’s needs and wishes.

We saw a complaints procedure was in place and this provided information on the action to take if a person wished to raise any concerns.

There were clear lines of accountability. The service had good leadership and direction from the registered manager. People, their relatives and staff spoken with had confidence in the registered manager and felt the agency was well managed. We found there were systems in place to assess and monitor the quality of the service, which included feedback from people using the service.

On our last inspection on 23 September 2013 people were not always protected from the risks associated with the unsafe management of medicines. Following the inspection, the provider sent us an action plan stating these issues would be addressed by 31 December 2013. We visited the agency again on 7 January 2014 to check the actions taken and found the necessary improvements had been made.

We found the policies and procedures relating to the management of medication had been revised and updated to include guidance on the application of creams. People’s care plans had also been updated where necessary to inform staff about the assistance they required with the administration of external preparations.

All staff had received medication awareness training within the last 12 months and there were arrangements in place to check their competency every three months as part of the supervision process.

People using the service told us they were satisfied with the way the agency delivered their care and support. People said they had a good relationship with members of staff and confirmed the staff took a flexible approach to their work. One person told us, “Everything has been very good; I can’t praise them enough”.

People were involved in their assessment of needs and the development of their care plan. People’s views were taken into account and they were therefore able to influence the delivery of their service.

Whilst suitable policies and procedures were in place for the management of medication, we found information in people’s care plans about assistance with medication was limited and unclear.

Appropriate checks were undertaken when new staff started working for the service.

There were systems in place to monitor and assess the quality of the service. People were given the opportunity to complete a customer satisfaction questionnaire twice a year. We saw the results of the questionnaires completed in August 2013 and noted people had a high level of satisfaction with the service.

People using the service told us they were satisfied with the way the agency delivered their care and support. People said they shared a good relationship with their regular care staff who they described as “very good” and “helpful”.

People were involved in their assessment of needs and the development of their care plan. People’s views were taken into account and they were therefore able to influence the delivery of their service.

People were satisfied with the support they received with their medication and confirmed they received their medication when they needed it.

Staff were provided with appropriate training opportunities and received regular supervision.

There were effective systems in place to monitor and assess the quality of the service.

People using the service told us they were satisfied with the way the agency delivered their care and support. People said they shared a good relationship with the staff who they described as “caring” and “helpful”. One person said “I can’t say enough about how good they are”.

People were involved in their assessment of needs and the development of their care plan. Their views were taken into account and they were therefore able to influence the delivery of their service.

People were satisfied with the support they received with their medication. However, some of the records and policies and procedures were not up to date, which meant there was the potential for error.

People felt the manager and the staff team were approachable and accessible and they could talk to them at any time if they had any concerns or queries. People were given the opportunity to complete a satisfaction questionnaire every six months and all the people who responded indicated they were satisfied with their service. However, people had not received feedback about their participation in the survey and any action taken by the agency in response to their comments. None of the people spoken with had any concerns about the service.