This inspection team was made up of an inspector. We considered our inspection findings to answer questions we always ask; 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. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People's needs were assessed and risk assessments were carried out before care was provided. These were regularly reviewed so that staff were aware of the best way to provide support.
The manager and other supervisors were available on a daily basis and out of office hours to oversee the staff, and monitor that people were being safely supported, for example in helping people to be safe during personal care. We were told by 12 staff and by 35 people we spoke with who used the service that staff were usually on time and provided their support safely. For example one person said, 'the staff know me very well and I feel very safe in their hands.' Another person said, 'I can't fault the staff and they seem to be well trained and take care of all my needs.'
There were arrangements in place to deal with emergencies and to make sure people were safe. People's health needs, such as physical disability support were included in their care planning to ensure that important health needs were met.
Staff carried photographic identification issued by the agency, to ensure that people who used the service were able to identify them and feel safe. All of the 35 people we spoke with who used the service or their relatives said that the staff always carried identification, and they felt that this was reassuring and gave them confidence about their security.
Is the service caring?
We spoke with 35 people who used the service or their families and people told us that the staff and supervisors were very caring and supportive. Many said staff always took the time to speak with them and spoke with them in a manner they understood. One person said: 'the staff are very polite and nothing is too much trouble to them.' Another person said:' I think the standard is high, the staff are good people to have in my home.'
Is the service effective?
We saw from 16 people's records we looked at that people's needs were assessed and a plan drawn up to meet those needs. Staff we spoke with were aware of the importance of seeking people's consent for the care provided such as medicines management, and people were asked for their consent before care was provided. People we spoke with told us they were happy with the plan provided. People's support plans were reviewed and changed when necessary in response to changing needs, for example in negotiating higher levels of support when necessary, or in changing the time of visits to accommodate people's needs such as activities. People and their families told us they were involved in the reviews.
There were suitable policies in place for consent to care, assessing and planning care, safeguarding people and managing medicines. All of the people we spoke with told us the staff knew how to support them well. People who used the service were consulted for their views on the service they received on a regular basis, which involved the person, their family or advocate and social services. We saw that any changes they requested were included in a revised care plan.
Staff were provided with adequate support, guidance and training to do their job. They were experienced in supporting people with care needs such as dementia and physical disabilities and they told us that the training they received equipped them to support people with confidence.
Is the service responsive?
People we spoke with who used the service told us that the staff and manager always listened to their concerns and did something to help sort out any problems they were experiencing. Almost all of the people we spoke with told us that the agency took care to ensure that they were happy with the staff allocated to them at the start of, and throughout care provision. For example one person said 'I was not happy with the staff as we didn't seem to understand each other and the agency swapped for another staff and I am happy with them'.
People's complaints and concerns were listened to and acted on promptly by the agency. We saw that complaints received had been recorded and responded to and three people we spoke with who had made a complaint said the agency had acted quickly in changing the time of the care provided to meet their specific personal needs, such as to ensure they were able to be ready to go to church on Sunday.
Is the service well led?
The registered manager was qualified and experienced and was involved in the day to day management of the service. There was an out of office hours on call system in operation to ensure that management support and advice was always available. There was a system for doing spot checks on staff working with people to monitor the quality and safety of care provided. Comments received from people who used the service and families included: 'The supervisors are very good and regularly call in to see how the staff are doing, I once had a problem with one staff and it was dealt with immediately,'
12 staff we spoke with told us that they felt the agency was very well managed and they received direction and training to help them to support people. Regular staff meetings and supervision sessions were held, and staff said they felt able to raise any issues with the management openly and honestly, and felt the manager followed up on any issues quickly.
There were a range of systems in place to monitor the quality of people's care, and to make sure any concerns about staff, management or the way in which care was delivered were addressed. This included quality assurance procedures and processes for checking that people's care was being planned and for asking people for their views about their care. The majority of people who used the service we spoke with told us that they felt the agency was well managed, and that they had regular contact from the office to check that their support was happening as planned.