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Inspection carried out on 7 January 2016

During a routine inspection

The inspection took place on 7 and 8 January 2016 and was announced. The provider was given 48 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office.

Peninsula Care Devon provides a personal care service to people living in their own home. On the day of the inspection 53 people were supported by Peninsula Care Devon with their personal care needs.

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.

On the day of the inspection staff within the office were relaxed, there was a calm and friendly atmosphere. Everybody had a clear role within the service. Information we requested was supplied promptly, records were clear and easy to follow.

People spoke well of the care and support they received, comments included, “The carers are first class in every way and thoroughly deserve that level of praise”, “You have to be caring to do the job they do and they all are; they’re wonderful” and “The carers are all so kind, I look forward to them coming to see me, I’m looked after really well”. Care records were personalised and gave people control over all aspects of their lives. People’s preferences were identified and respected. Staff responded quickly to people’s change in needs. People were involved in reviewing their needs and expressed how they would like to be supported and by whom.

People were supported by staff who put them at the heart of their work. Staff showed a kind and compassionate attitude towards people. Relationships had been developed and staff had an appreciation of how to respect people’s individual needs around their privacy and dignity.

People’s risks were managed well. People were promoted to live full and active lives. People were supported to have as much control and independence as possible.

People had their medicines managed safely. People were supported to maintain good health through regular access to health and social care professionals, such as GPs and district nurses.

People told us they felt safe. Comments included, “I absolutely feel safe, they notice when things are wrong, sometimes before I do and that makes me feel safe” and “I do feel safe, I welcome them coming because then I know I’m getting the help I need to be safe” and “It’s nice to have people coming to see me and when they leave, they make sure everything is all locked up and that I’m safe”. Staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge on how to report any concerns and described what action they would take to protect people against harm. Staff told us they felt confident any incidents or allegations would be fully investigated.

People were supported by staff who had limited knowledge of the Mental Capacity Act (2005) (MCA). The service did not currently support anybody who required an assessment under the MCA. The registered manager confirmed all staff would receive MCA training as a matter of importance.

People were supported by staff who had received a thorough induction programme and on-going training to develop their knowledge and skills.

People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment.

The service had a policy and procedure in place for dealing with any concerns or complaints. There had been no written complaints received by the service in the last twelve months.

Staff described the management to be supportive and approachable. Staff talked positively about their jobs. Comments included, “I’m definitely motivated, […] thinks the world of us”, “[…] is always willing to invest in his staff, progress staff and support them to achieve” and “I love my job, I absolutely love it. It is challenging but amazing”.

There were quality assurance systems in place to drive continuous improvement within the service. Audits were carried out and where shortfalls in the service had been highlighted, action had been taken to resolve the issues and help ensure quality of care was not compromised.

Inspection carried out on 6 December 2013

During a routine inspection

Agency staff supported people with a range of needs, including those who required some support in regard to their personal care.

All the people we spoke with who used the service told us they felt respected and involved in the planning of their care. One person said "I am very happy, they support me with my independence and always ask if they can do anything else." They added "I can make changes anytime to the daily tasks I need help with, they are very obliging."

We saw that prior to using the service, people and or their representatives met with the provider to discuss care packages. Records showed that further information was gathered about the person's history, detailing their likes, dislikes and specific needs they had. This meant that the needs of the people using the service were fully assessed and ensured that the provider could meet their needs.

All staff were trained in safeguarding and identifying abuse. All new staff had safeguarding covered in their induction programme. We spoke with three staff members who told us they were trained and able to recognise signs of abuse. All were able to report the procedure for escalating concerns and detail types of abuse.

Staff received an appropriate induction programme which included shadowing experienced care workers and some learning around the essential areas relating to care work. A staff handbook was issued and this formed part of an ongoing training and supervision tool.

The manager worked with staff to have an on-going review of the needs of those using the service. They worked closely with Social Services when a person's needs had increased beyond what they could safely manage at home. This demonstrated that the service were able to identify that people were being supported in the best place for their needs.

Inspection carried out on 24 October 2012

During a routine inspection

This was a scheduled inspection and was carried out over three days on 24, 25 and 26 October 2012. On the first day we made an unannounced visit to the agency's office where we talked with the registered manager and administrative staff. We looked at records and documents held in the agency's office that related to the care people received, safeguarding people from abuse, staff training, quality assurance and the procedures for handling people's money.

At the time of this inspection the agency provided services to 48 people and the agency employed 26 care workers.

On the second day we spoke by telephone, with four care workers who provided the personal care to the people using the service. On the third day we spoke on the telephone with four people using the service or their relatives. We spoke with a further person on the 30 October 2012. We offered to visit people in their homes but they were happy to speak by telephone.

People who received care from the agency and their relatives were very positive about the way they were treated by care workers. One relative told us “They look after my relative very well, we have no complaints”. A person receiving the service told us “They (the staff) are always happy and polite and they turn up on time”.

People said that the agency was reliable. The registered manager sought people's views and took action if areas of improvement could be made to ensure people received good standards of care and support.