We visited the office of the domiciliary care agency and homes of four people who used the service during this inspection. We subsequently phoned four other people who received personal care from the agency to ask about their experience of using 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?:-
People told us they felt safe and trusted the staff. One person said they, 'Feel safe and reassured by service' and that staff, 'Don't take advantage in any shape or form.' Safeguarding procedures were robust and staff understood how to safeguard people they supported.
We saw evidence in people's records that consent to their support was discussed and explored with them at the commencement of their use of the service. We saw people or their relatives had signed to confirm their agreement with the way this was provided. This helped ensure their rights and dignity was respected.
Systems were in place to ensure managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
Staff knew about risk management plans and we were able see examples of how these were followed. People were not put at unnecessary risk and were included in decisions about their support and remained in control of their care and their lives.
Recruitment practice included checks to ensure new staff were safe to work with people who used the service. Policies and procedures were in place to make sure unsafe practice was identified and people were protected.
Is the service effective? :-
People told us they were involved the development of their plans of support and were consulted about their assessment of their health and care needs.
People told us their care plans were reviewed to reflect their needs. One relative told us that support had been recently increased following a change in their needs.
Is the service caring?:-
We spoke with eight people or their relatives who were supported by the service. We asked them for their opinions about staff who supported them. Feedback from people was overall very positive about staff. For example; one person said care staff were, 'Reliable' and 'Friendly' whilst another said staff were, 'Absolutely marvellous' and that they were, 'Very satisfied' and 'Happy with the service.'
They told us that office staff contacted them about possible changes in their routines of support and that care staff had, 'Never missed a call.' We observed office staff arranging alternative cover for a call they were notified about at short notice. We saw this was managed calmly and professionally and were subsequently told this matter was satisfactorily addressed before the end of the shift.
When speaking with staff it was clear they cared for the people they supported. People and their relatives indicated they were regularly consulted about their views concerning the way the service was provided. They told us that where shortfalls or concerns were raised, these were taken on board and dealt with appropriately.
We saw evidence that people's preferences, interests, aspirations and individual needs were recorded and that care and support was provided in accordance with their wishes and feelings.
Is the service responsive?:-
People told us they knew how to contact the office and raise a complaint if needed. People told us they were confident appropriate action would be taken by the provider to address any concerns they might have. This helped ensure that complaints would be listened to and followed up where required
Is the service well-led?:-
The service has 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.