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Inspection carried out on 25 February 2019

During a routine inspection

Quality Care Devon is a domiciliary care service registered to provide personal care and support to people living in either their own homes or with family members within the Torquay area.

Not everyone using Quality Care Devon received a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; such as help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 114 people receiving personal care.

The service had a registered manager in post. 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.

At the last inspection in August 2016 the service was rated Good overall. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service remained rated Good.

People commented; “We are very well looked after and cared for” and “The best I’ve had, couldn’t have better”. A relative said; “I need to know my loved one is treated with respect, and they are.”

People continued to be safe using the service. People were protected by safe recruitment procedures to help ensure staff were suitable to work with vulnerable people. People had their needs met by suitable numbers of staff, with extra staff support provided when required.

Peoples’ medicines were managed safely. Staff completed medicines training and knew and understood the importance of safe administration and management of medicines.

People were protected from abuse because staff knew what action to take if they suspected someone was being abused, mistreated or neglected. Staff completed safeguarding training.

Peoples’ risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments were completed to help support and enable people to retain as much independence as possible and help reduce risks from occurring. Risks associated with people's care and living environment were effectively managed to ensure their freedom was promoted.

People received effective care from staff who had the skills and knowledge to meet their needs. Staff confirmed they attended team meetings, received one to one supervision and appraisals to monitor their practice. Staff without formal care qualifications completed the Care Certificate (a nationally recognised training course for staff new to care). Staff said the Care Certificate training looked at and discussed the Equality and Diversity policy of the company.

People were enabled and supported to lead fulfilling, independent and active lives. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's human rights were protected because the registered manager and staff had an understanding of the Mental Capacity Act 2005 (MCA).

People who required assistance with their food, made a choice of meals, snacks and drinks they enjoyed. Staff monitored people's health and well-being and made sure they had access to other healthcare professionals according to their individual needs.

People continued to receive a service that was caring. Staff demonstrated kindness and compassion for people through their conversations and interactions. If people found it difficult to communicate or express themselves, staff offered additional suppor

Inspection carried out on 10 August 2016

During a routine inspection

Jayden House provides personal care and domestic support to people who live in their own homes.

The service has a registered manager, although they were not available at the time of the inspection. 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.

The inspection was undertaken over a three day period, 10, 15 and 17 August 2016 and included visits to the office, staff interviews and visits and telephone calls to people in their own home. At the time of this inspection 128 people were using the service.

This was the first inspection of this service since it registered with the Care Quality Commission, (CQC).

The majority of people we spoke with said the service was well managed. One person said, “They deal with everything I ask them to” and another said, “I can’t find fault at all.” Any reservations people had related to the changes made to the care staff rotas, although two people said they had a delay in obtaining a response from the office staff, and didn’t always feel listened to. The registered provider was aware of these issues and was taking practical steps to resolve these and improve the service. They had invested in a new electronic monitoring system; provided staff with smart phones to enable them to access their rotas electronically; provided satellite navigations systems for staff; purchased pool cars for those staff who did not have their own car; paid for staff to take their driving test and provided a fuel card so staff did not have to purchase fuel themselves. The registered provider was confident these changes, along with creating geographical staff teams and strengthening the management structure, would ensure people received a more consistent service.

All of the 16 people and five relatives we spoke with told us the staff provided safe care and support. One person said, “I don’t have any qualms about that. I always feel safe.” Five people told us that sometimes their carers arrived late and two people told us they had occasionally had a missed visit. All said they were usually informed by telephone if the carer was running late. However, one person and one relative said staff had been very late and they had not been notified. One said the staff had been so late they had put themselves to bed, which was a risk to them, and the relative said their relation had become very distressed.

Some people told us they felt there were not enough staff to meet the service’s obligations to people, as they had experienced late visits or had their staff changed at short notice. Eight people were concerned about the number of changes made to their planned staff rota. One person said, “We very rarely have the same staff” and another said they were not sure who was coming to them until they arrived. We discussed this with the registered provider. They said there had been a period when the service needed to recruit more staff and this, along with the changes made to the staff teams, had resulted in periods of change for people. They were confident this would all now be resolved.

Staff recruitment practices were safe and relevant checks had been completed. All four files we saw included the necessary pre-employment checks, including proof of identify, previous employment references and a disclosure and barring service (police) check. Staff had received training in safeguarding adults and knew how to recognise signs of potential abuse. They understood how to report any concerns in line with the service’s safeguarding policy. One member of staff said the service was very good at looking after people’s welfare: they said, “We keep an eye on people, make sure they are safe.”

Risks to people’s health and safety had been assessed and regular