Twilight Years Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community in the Furness and South Lakeland areas of Cumbria. The service is provided to adults with a range of physical and mental health care needs.

Not everyone using the service receives regulated activity; CQC only inspects the service being received by people provided 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.

At our last inspection of this service between June and August 2015 we assessed the overall rating to be good. However we assessed the key question of safe to be requires improvement. At this inspection in February and April 2018 the rating for the key question of safe had improved to good. 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 this inspection we found the service remained Good.

At our comprehensive inspection of this service in 2015 we found a breach of legal requirements. Although people had been protected against the risk of harm, the records around medicines did not identify the medicines that people had taken. This meant it was not possible to check that people had been supported to take their medicines as their doctor had prescribed.

After that inspection the registered provider wrote to us to say what they would do to meet legal requirements in relation to the breach. At our inspection in February and April 2018 we looked at the actions the registered provider had taken and found that legal requirements had been met.

People were safe receiving care from the service. Hazards to people’s safety had been identified and managed. The staff understood how to protect people from abuse and harm.

New staff were recruited safely. All new staff were checked to ensure they were suitable to work in people’s homes.

There were enough staff to provide people’s care. The staff were trained to ensure they had the skills and knowledge to provide people’s care.

The registered manager and care staff worked with local health and social care services to ensure people received the support they required. People received their medicines safely and were supported, as they needed, to access local health services.

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. People could refuse any part of their planned care and the decisions they made were respected.

The staff treated people in a kind and caring way. Care staff told us their visits were planned so they had time to spend with people and understood this was important in supporting people’s wellbeing. However, some people felt the staff were rushed and required more time to provide their care. This was discussed with the registered manager.

Care was planned and delivered to meet people’s needs. People who used the service were included in planning and reviewing their care.

The registered manager was supported by an office manager and team of care coordinators. People who used the service knew how they could contact a member of the management team if they needed.

The registered provider had a website which gave information about the services provided, how people could contact the agency and how people could raise a complaint. People had access to important information about the service.

The agency worked with appropriate services to support people who were reaching the end of their lives.

The registered manager had systems to monitor the quality of the service. People were asked for their

We spoke with 16 people who used this service. Everyone we spoke with said that the care staff who visited them treated them, their families and homes with respect. People told us that they felt safe with the staff who supported them.

People told us they knew how to contact the agency if they needed to. Where people had asked for a change to the service they received, they said this had been agreed.

Everyone we spoke with said they were able to refuse any part of their planned care if they wished.

Most of the people we spoke with told us they were happy with the care staff who visited them.

They told us,

“The staff are very good, I have never had any trouble whatsoever. I have regular carers and have been very lucky”,

And said, “My carers are very, very good, I couldn’t ask for any better”.

Some people said that they were supported by a number of different care staff. They told us that, while they were generally happy with the care staff who visited them, they would prefer to receive support from care staff who they knew.

The people we spoke to told us Twilight Years Limited provided a good quality service. People said they were “100% happy” with the service provided and said they would “whole heartedly recommend” the agency to other people. Everyone we spoke to told us they had been asked about the care they needed and said the care staff who supported them treated them, their families and homes with respect.

People told us:

“All the staff who visit are well trained. I couldn’t do without them.”

“I can't praise the carers enough.”

And said, “If I have any concerns I just ring the office, I’ve always found them to be very cooperative.”

The people we spoke to told us Twilight Years Limited provided a good quality service. People said they were “very happy” and “satisfied” with the service provided and said they would recommend the agency to other people. Everyone we spoke to told us they knew who they could speak to if they had a concern or complaint and said they would be confident raising concerns with the manager of the agency.

People told us:

“If I make any request at all they do their utmost to accommodate me.”

“I’m comfortable with the staff who come here and I like having the continuity of having the same staff.”

And said, “I can't think of anything I'd want to see changed or how they could do things better, I'm very happy with them”.

This announced inspection took place between 24 June 2015 and 11 August 2015. We last inspected this service in October 2013. At that inspection we found that the provider was meeting all of the regulations that we assessed.

Twilight Years Limited provides personal care and support to adults living in their own homes. The agency is based in Barrow in Furness and provides support to people in Barrow, Dalton, Ulverston and the surrounding areas. Services offered by the agency include personal care, shopping, housework and preparing meals.

There was a registered manager employed at the service. 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 were treated with respect and included in agreeing to the support they received. There were enough staff to provide the care that people required. The staff knew the people they supported and were kind and caring to people.

Although people were protected against the risk of immediate harm, the records around medicines did not identify the medicines that people had taken. This meant it was not possible to check that people had been supported to take their medicines as their doctor had prescribed.

People received the support they required to remain living at home. They knew the staff who supported them and valued the care that the staff provided. The staff took appropriate actions to protect people’s privacy and dignity and to support their independence.

The service was well managed. The registered manager listened to people’s views and took action in response to any concerns raised. All new staff were checked to make sure they were suitable to work in people’s homes. The registered manager monitored the quality of the service. Areas which required improvement were identified and actions taken to address them.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to accurate records not being kept of the medicines people had taken.

You can see what action we told the provider to take at the back of the full version of the report.