The inspection took place on 30 March 2016 and was announced. We gave the provider 48 hours’ notice because the service is a small home care agency and the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in. `Lutterworth and Rugby’ is a home care agency supporting people who live in their own homes in the Lutterworth and Rugby area. At the time of our inspection 43 people used the service. Of those 19 received personal care; the others received support which we do not regulate.
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 were cared for and supported by staff who had excellent training and support to ensure that they understood their needs and how to meet them in the best ways. The training was innovative and staff were supported to put their training into practice. People using the service and their relatives spoke about the effectiveness of staff in consistently complimentary and positive terms. Staff were also supported through supervision and appraisal and they valued the support they received, including support to study for further qualifications.
The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. Staff had awareness of the MCA and understood they could provide care and support only if a person consented to it and if the proper safeguards were put in place to protect their rights.
Staff made special efforts to support people to have meals they enjoyed. They also supported people to access health services when they needed them. They had training about people's medical conditions and were able to recognise if a person's health deteriorated. When people needed it they took appropriate swift action to support the person to access health services. People and their relatives told us that they received care and support that had a significant positive impact on their lives.
People using the service and their relatives told us consistently that they held staff in high regard. The registered manager `matched' staff with people using the service which meant people were supported by staff who naturally empathised with them. Staff were caring and knowledgeable about people’s needs. People were consistently supported by the same staff who had developed caring relationships with them.
People were involved in decisions about their care and support. They received the information they needed about the service and about their care and support. They told us the information was clear and easy to understand.
People told us they were always treated with dignity and respect. The registered manager actively promoted values of compassion and kindness in the service.
People contributed to the assessment of their needs and to reviews of their care plans. Their care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to and they were confident they would be taken seriously by the provider. People told us they had never had a reason to raise a concern. When people expressed preferences about their care and support these were acted upon by the service.
People who used the service were consistently safe. They were supported and cared for by staff who had been recruited under highly robust recruitment procedures that ensured only staff who were suited to work at the service were employed. The recruitment procedure placed great emphasis on kindness and compassion and people were not recruited unless they displayed those characteristics. Staff understood and discharged their responsibilities for protecting people from abuse and avoidable harm. They advised people about how to keep safe in their homes.
People’s care plans included risk assessments of activities associated with their personal care routines. The risk assessments provided information for care workers that enabled them to support people safely but without restricting their independence.
Enough suitably skilled and knowledgeable staff were deployed to meet the needs of the people using the service. This meant that home care visits were consistently made at times that people expected. Staff arranging home care visits were knowledgeable about people’s needs and ensured that people were supported by care workers with the right skills and knowledge.
People were helped to receive the medicines that they needed by staff who were trained in this area. Staff also advised people about the safe storage of medicines. They reported any concerns about this to the registered manager who took prompt and effective action to support people to make keep their medicines in a safe and secure place.
The registered manager and staff were consistently highly regarded by people using the service, their relatives. The service played a role in the local community and collaborated with other services to raise awareness of dementia. The service had won awards and recognition from outside bodies.
The provider had effective arrangements for monitoring the quality of the service. These arrangements placed a high value to people’s feedback which was acted upon. The quality assurance procedures were used to continually improve people’s experience of the service. The registered manager's aim was to have as near a perfect service as possible for people currently receiving care and support before expanding the service to provide care and support for more people.