We visited the office of the domiciliary care agency together with the homes of two people who used the service as part of this inspection. We subsequently phoned five other people or their relatives, to ask them about their experience of the service and spoke to staff who supported them.The inspection gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found:
Is the service safe?:-
We saw evidence in people's care records that consent to their support was discussed and explored with them at the start of their use of the service. We saw people or their relatives had signed to confirm their agreement with the way support was provided. This helped ensure people's dignity was respected and their human rights were protected.
People told us they felt safe and that staff were reliable. One person said, 'The girls are marvellous, there is not one I would not employ.'
We found that safeguarding procedures were robust and staff understood how to protect vulnerable adults and children from harm.
We saw that systems were in place to ensure managers and staff learnt from events such as incidents and accidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
Staff knew about risk management plans for people who used the service and we saw examples in people's care records of how these were followed. We saw evidence that people were included and involved in decisions about their support to enable them to feel in control of their care and not put at unnecessary risk of harm.
Recruitment practices included checks to ensure new staff were safe to work with people who used the service. Policies and procedures were available to make sure unsafe care practices were identified and that people were protected from harm.
Is the service effective?:-
People told us they were involved in the development of their plans of support and were consulted during the assessment of their health and care needs. People told us their care plans were updated and reviewed to reflect changes in their needs.
Is the service caring?:-
We saw evidence that people's preferences, interests and individual needs were recorded in their care records and that care and support was provided in accordance with their wishes and feelings.
People told us that the office staff were good at contacting them about possible changes to their routines of support. However one person said this could be improved at times such as holidays, or when staff were off sick and replacement staff were needed. Everyone we spoke with told us they had never experienced a 'missed call' (i.e. when staff fail to turn up) and that care staff were reliable.
When speaking with staff it was clear they knew about the needs of the people they supported. People who used the service and their relatives indicated they were regularly consulted about their views concerning the way support was delivered. We observed that unannounced visits or 'spot-checks' took place to people's homes to ensure care staff support was correctly provided. People who used the service told us that where shortfalls or concerns were raised, these were taken on board and dealt with appropriately by the provider.
Is the service responsive?:-
People told us they knew how to contact the office and raise a complaint if this was required. They told us they were confident appropriate action would be taken to ensure any concerns they might have were followed up and appropriately addressed. This helped ensure complaints would be listened to and followed when needed.
Is the service well-led?:-
The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.
What people who used the service and those that matter to them said about the care and support they received:-
We spoke with seven people who used the service or their relatives about the support they received and asked them for their opinions about staff. Feedback from people was very positive overall. One person said care staff were, 'Always polite and respectful.' They told us staff, 'Listen and talk' to them to ensure they were involved in decisions about their support. People said that care staff did not rush and took their time and that they were, 'Always punctual'. Whilst another person told us, 'I can't fault the care.'