We spoke with three people who used the service (two with a family member present), the registered manager and the provider during this inspection. We also looked at records and quality assurance systems. This helped answer our five 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 who used the service or their relatives said "The staff are trustworthy. We feel safe and they leave the property secure", "As far as I am concerned they are trustworthy and reliable. You can get hold of them in an emergency" and "They are reliable. I get the same staff more or less so I know who is coming. I have no doubt to judge their honesty". People felt secure with the staff who looked after them.
People who used the service or their relatives said, "I am aware I can talk to the owner about any issues and I am sure he would listen", "If I had any concerns they would listen to me. We don't have any complaints" and "I could contact the office and do if I need to but it's not to make a complaint. I don't have any". Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations.
Staff files showed staff were robustly recruited to work with vulnerable adults in their own homes.
Is the service effective?
Staff files showed that staff had been trained in mandatory topics such as health and safety, first aid, food hygiene, fire awareness, safeguarding, moving and handling, infection control and the administration of medication. Further training was available such as dementia and diabetes care, end of life care and a nationally recognised qualification in health and care such as a diploma or NVQ. Staff were sufficiently trained to deliver effective care.
People who used the service told us, "The owner came a few times before we used the service. He explained what they provided. They gave us enough information before we used the service so we knew what we were getting", "They gave us a lot of information before we used the service" and "I had all the information I needed before I used the service. It's in my folder". People were given sufficient information to make a choice to use this agency.
People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing them and they reflected their current needs. People we spoke with were very satisfied with the care they received.
People who used the service lived in their own homes but were encouraged to become independent if their condition allowed it.
Systems were in place to make sure that managers and staff learn 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.
Is the service caring?
People who used the service or their families told us, "The care staff and service is very good. They sit and talk to him. The owner is excellent and will come himself if he needs to", "The care staff look after me very well. They take me shopping. They are very good and look after me" and "The staff are all lovely". People were supported by kind and attentive staff.
People who used the service, their family, friends and other professionals were asked about their views of the agency. One person told us, "Sometimes they come to talk to me to see how I am doing and if my care is OK". This included an annual survey which we looked at and saw the positive results. Part of the survey asked all concerned what they thought the service could do to improve. The provider used the comments and surveys to improve the service.
Is the service responsive?
People who used the service had a wide range of interests and hobbies. People completed a range of activities in and outside the service regularly. This included going out shopping, visits to places of interest and life skills in the home.
The service conducted audits with people who used the service on a regular basis to ensure they received the care they needed. Staff were 'spot checked' to ensure they arrived at the right time and documentation, for example, the care plan was audited by managers to make sure the care and plan was accurate.
Is the service well-led?
We saw that the service worked well with other agencies and organisations. Some specialist organisations provided possible 'clients' because of the way the agency looked after people.
The service had quality assurance systems in place and records showed that people who used the service and other organisations were happy with the service provided. All the people we spoke with were very satisfied they could talk to management and were aware it was a twenty four hour a day service. Staff felt supported. As a result the quality of the service was continually improving.
Staff had access to a handbook and the skills for health and social care codes of conduct. This gave staff the information to know what was expected of them.