This inspection took place on 1 March 2017. Welcombe Care provides domiciliary care to people living in their own homes, mostly within the Stratford upon Avon area. At the time of our inspection, the agency supported 40 people, of which, 32 were supported with personal care by 17 care staff.

This service registered with us in July 2015 and had not been previously inspected. This was the first rating inspection.

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 felt safe with the staff who supported them. Staff received training to safeguard people from abuse. They were supported by the registered manager, who ensured staff followed safeguarding protocols and procedures. Staff understood which actions to take in order to protect people from abuse. Risks to people’s safety were identified however, some risk assessments required more detail, especially those people identified at medium risk or higher. However, staff knew people’s current risks and how they should be managed. The registered manager agreed to improve people’s risk assessments so staff continued to provide consistent and safe care.

Some people were given their medicines by staff who were trained and assessed as competent to give medicines safely. Records showed people’s medicines were given in a timely way and as prescribed. Checks ensured medicines were managed safely and staff were observed by the registered manager and senior staff to ensure they were competent to do so.

There were enough staff to meet people’s needs effectively, and people told us they had a consistent and small group of staff who supported them, which they appreciated. The provider had a thorough recruitment process which included pre-employment checks prior to staff starting work. This helped ensure their suitability to support people who lived in their own homes.

People told us staff sought their consent before undertaking any personal care tasks. Where people were able to make their own decisions, staff respected their right to do so. One person’s ability to make some of their decisions had been assessed by other health care professionals, but limited records confirmed the outcome of any mental capacity assessments. The staff team and the registered manager worked within the principles of the Mental Capacity Act.

People and relatives told us staff treated them with dignity, kindness and respect. People’s privacy was maintained and people felt comfortable when staff supported them with personal care.

The registered manager and provider sought regular feedback from people and made improvements to ensure they were proactive in improving the service people received.

People saw health professionals when needed and the care and support provided was in line with what was recommended. People’s care records were written in a way which helped staff to deliver personalised care and gave staff information about people’s communication, mobility and preferences. Some care plan records required some improvements, such as more information about the person, and actions to take where risks where identified. People were involved in how their care and support was delivered.

People and relatives felt able to raise concerns with the registered manager and were confident they would be listened to and responded to in a timely way. Staff told us the provider, registered manager and office staff had an ‘open door’ and were approachable and responsive to ideas, suggestions and sharing concerns. There were systems to monitor the quality of the support provided.