We spoke with the registered manager and the provider. We also spoke with four care workers. We reviewed records that related to supporting workers and assessing and monitoring the quality of the service. These included five people's care plans, five staff training records and quality assurance records.
If you want to read the evidence that supports our summary please read the full report.
Is the service safe?
The service was not safe because staff did not receive all the appropriate training to carry out their role. The most up to date records were not always present in a person's home which meant staff may not be aware of the current agreed plan of care or risks to a person's safety. Compliance actions have been set for these areas and the provider must tell us what they intend to do to meet these.
Staff understood how to protect vulnerable people in their care and knew how to report any concerns they had.
There were detailed plans of care and risk assessments documented which were held in the office. These documents were not always consistent with those present in a person's home.
People told us they felt safe and confident with the staff who provided the care and support.
All the relevant information was obtained prior to a new person starting work, to ensure they were fit to work with vulnerable adults.
Staff received a high level of supervision when they first starting working at the service and a continued regular observation of their practice. This showed staff were supported in their work and opportunities to ensure they were following correct procedures were in place.
Is the service effective?
The service was effective because people told us they received the care and support they required in a manner which met with their choices.
They said the staff were mostly on time and they were informed if there was going to be a delay. They could access a rota so they knew who was going to visit them.
Is the service caring?
The service was caring because staff treated people with dignity and respect, addressing them politely and showing patience.
People said the care was 'Excellent' and one person said 'I don't think it could be better.' They described the staff as 'Very helpful,' 'Very caring and kind' and 'Wonderful.'
Is the service responsive?
The service was responsive because people felt in control of their own care and were involved in how they were supported and assisted.
They told us the service was flexible to meet their needs with two people telling us specific visits had been made in order to assist them early in the morning before other appointments.
Staff understood when there was a need to involve other health professionals, including in an emergency.
Is the service well-led
The service was well-led in terms of the organisation of the systems of care and support for people and the support for staff.
The records were not always up to date. Some of the specific care records, in a person's home, were not the latest ones developed. Some policies and guidance in the office were not kept up to date.
This inspection was carried out to follow up on concerns identified at previous inspections. As part of the inspection we spoke with the provider and manager of the service and looked at care records.
We found that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were up to date risk assessments in place which identified possible risks to people regarding the care they received. This meant that care staff had the information they needed to keep risks to a minimum.
There were systems in place to notify the CQC about incidents which affected the health, safety and welfare of people who used services. We noted that there had been no reportable incidents in the last six months.
We found that improvements had been made since our last inspection. One person told us "It has very much improved". Another said "The office is now much better organised".
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. However, risk assessments did not always provide sufficient information to ensure people's safety and welfare.
There were appropriate systems in place to make sure that people were protected from the risk of abuse.
We found that the procedure for recruitment was robust and that all necessary pre-employment checks were undertaken. Staff were supported in their roles and received the training they needed in order to support people effectively.
The provider had systems in place to monitor the quality of the service. People were asked for their views and action was taken to make improvements where needed.
Three of the four people receiving a service and three of the four nearest relatives who we spoke to told us that there had been times when carers had not performed their duties competently.
These responses indicated that people feel their dignity and privacy are being respected, and that care visiting arrangements are consistent and meet their needs. People feel well supported by the staff attending to them.