The inspection of Westhope Care Limited – 11 Kings Court took place on 4 April 2017 and was announced. The provider was given 24 hours' notice because the location provides a domiciliary care service; we needed to be sure that someone would be available in the office.

The service is a domiciliary care agency. The agency provides services that are based in a person's own home and in supported living services in the community. The supported living service is provided to people in order to promote and maintain their independence. People's care and housing are provided under separate agreements; this inspection looked at their personal care and support arrangements. At the time of our inspection, the agency was providing a service for 22 people with a variety of care needs, including people living with a learning disability or who have autism spectrum disorder. Seven people were in receipt of personal care. The agency was managed from an office based in Horsham, West Sussex.

At the time of the inspection, there was a registered manager 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.

At the last inspection on 15 February 2016, we identified one breach of Regulation associated with Fit and proper persons employed. Whilst identity and security checks had been completed for new staff, full work histories had not always been obtained and gaps in the employment history of some staff had not been accounted for. At this inspection, we found that the actions had been completed and the provider had met all the legal requirements. Robust recruitment and selection procedures were in place and appropriate checks had been made before staff began work at the service. There were sufficient levels of staff to protect people's health, safety and welfare in a consistent and reliable way.

At the last inspection on 15 February 2016, we recommended the provider seek good practice guidance in relation to recording the administration of medicines in people's own homes. People's medicines were administered by staff that were trained to do so. However, improvements were needed in relation to the recording of medicines. Following the last inspection, the provider wrote to us to confirm that they had addressed these issues. At this inspection, we found policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed safely.

At the last inspection on 15 February 2016, we found the delivery of care was tailored and planned to meet people's individual needs and preferences. People told us they were supported to participate in activities of their own choice however; staffing levels had limited the opportunities for some people to participate in activities they had planned for. This was an area of practice that we identified as needing to improve. At this inspection, we found that the good level of person centred care and sufficient numbers of staff meant people led independent lifestyles, maintained relationships and were fully involved in the local community.

Risks to people's wellbeing and safety had been effectively mitigated. We found individual risks had been assessed and recorded in people's support plans. Examples of risk assessments relating to personal care included moving and handling, nutrition, falls and continence support. Health care needs were met well, with prompt referrals made when necessary.

People told us they felt safe receiving the care and support provided by the service. Staff understood and knew the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safegua

This service provides support to people who require help with personal care. They specialise in supporting younger adults with a learning disability and associated conditions who live in their own homes. Most of the people supported by the service lived in one of two supported living services with a further six people living in their own individual accommodation. There were 24 people using the service at the time of our inspection.

We inspected this service on 15 February 2016 and the inspection was announced. This was to make sure there would be someone available in the office to facilitate our inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

Whilst identity and security checks had been completed for new staff, full work histories had not always been obtained and gaps in the employment history of some staff had not been accounted for. Therefore the provider could not be assured these staff were suitable to work with adults at risk.

People’s medicines were administered by staff that were trained to do so. However improvements were needed in relation to the recording of medicines and we have made a recommendation that the provider seeks up to date good practice guidance on this issue.

The delivery of care was tailored and planned to meet people’s individual needs and preferences. People told us they were supported to participate in activities of their own choice however staffing levels had limited the opportunities for some people to participate in activities they had planned for.

People’s independence was promoted and people were supported to take risks. People were encouraged to undertake their own daily living tasks such as menu planning, cooking and cleaning. One person told us “I do my own cooking. I can do ready meals myself but if I’m cooking a meal then the staff watch me”. Some other people had been supported to find employment and voluntary work which they enjoyed and another person told us “I’m looking forward to getting my own flat. I’ve talked to (Staff members name) and my social worker about it”.

People and their relatives or representatives were involved in the development of their risk assessments and support plans. People had named key workers who supported them to co-ordinate their care who they met with on a regular basis to discuss what was working well and make plans for the future.

People looked happy and were relaxed and comfortable with staff. They were supported by staff who understood their needs and abilities and knew them well. One person’s relative told us “The staff clearly are fond of (person’s name) and he of them. Comments included on questionnaires that people completed included ‘I like everything here, nice people, understanding staff who ask how I am feeling.’ And ‘My care and support workers are caring and kind.’

People’s needs and preferences were met when they were supported with their dietary needs and people were supported to maintain good health. People confirmed they were supported to attend medical appointments and one person told us “Staff help us to make appointments. I’ve got an appointment for my teeth next week and staff will come with me because I can’t go on my own”. Another person’s relative commented “They care for his physical health problems, which have recently included difficulties with swallowing, so that he has to have a pureed diet and thickened drinks.”

The provider actively sought and included people and their representatives in the planning of care. There were processes in place for people to express their views and opinions about the service provided. The feedback from people and their representatives in th

We spoke with six people who use the service. We visited four people in their homes by prior arrangement and spoke with two on the telephone afterwards. People told us that they were satisfied with the service. One told us, “It’s good”. Another said, “Westhope Care is very helpful”.

We spoke with six care workers and the manager. Care workers told us that they enjoyed their work. One said, “I love it, it’s nice to know at the end of the day that you’ve helped people”. Another told us, “It’s a great service to work for”.

We found that people experienced safe and effective care delivered by regular staff who knew them well. The interactions between care workers and people that we observed during home visits were positive. People were offered choices about the care that they received and support was provided in a kind and respectful manner. Everyone that we spoke with told us that they could approach their care workers and the manager if they were unhappy or had ideas to discuss.

We spoke with three people who received support from the agency. They told us that they were pleased with the service. One said, “I’m definitely very happy with them”, another, “I think the staff are really helpful” and, “I feel involved”.

We spoke with one relative. They told us that, “Staff are very nice and very helpful”. They explained how their relative was always happy to go home after a visit with them and said that, “They seem to be very caring with him”.

We spoke with three care workers. They told us that they enjoyed working at the agency.

We found that people received care and support that met their needs. However, the provider’s quality assurance systems had not identified variations in areas including care planning and staff support.

People we spoke with told us that staff provide the support they need and that staff are trustworthy and punctual. They said they knew who was going to support them and when. They felt able to raise any concerns with the manager and that if they required additional support it would be provided. They told us that they are fully involved in writing their own care plans and that staff provide the support that has been agreed. We noted that the people that were unable to give us their views were being provided with individualised care that met their needs.