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Inspection carried out on 10 November 2017

During a routine inspection

This comprehensive inspection took place on 10 November 2017 and was announced.

Falcare is a domiciliary care agency that provides personal care and support to younger adults and older people in their own homes. At the time of our inspection 32 people were receiving a personal care service. Some people had short visits at key times of the day to help them get up in the morning, go to bed at night and give support with meals. Other people received longer visits to support them with their daily lives and other people received a 24 hour a day supported living service. A supported living service is one where people live in their own home and receive care and support to enable people to live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy

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.

We observed staff demonstrated an exceptionally caring, compassionate and kind attitude towards people. Staff exceeded what was expected of them routinely. On relative said; “They are amazing”. Feedback about the service from everyone we spoke with was positive. People were supported to achieve their goals and ambitions and staff went the extra mile to support them. Respect for privacy and dignity was at the heart of the service’s culture and values. People’s support was completely personalised and tailored to their individual needs. There was a strong focus on protecting people’s human rights and ensuring they did not experience discrimination in any form. People received compassionate care and attention at the end of their life.

There were numerous examples of how staff provided individual support for people who were supported by Falcare, to take part in activities and follow their interests. We found this had a hugely positive impact on peoples lives. People were supported to maintain their hobbies and interests and to try new experiences. Innovative ways were found to help people remain in their own home and live as independently as possible. Staff knew the people they supported very well and this enabled them to build strong, and supportive working relationships.

Staff were available to ensure people received continuous, attentive and discreet care and support. Staff responded to people’s choices as well as meeting their care and support needs in a way that suited the person. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible

People’s rights were protected by staff who under stood the Mental Capacity Act and how this applied to their role. Nobody we spoke with said they felt they had been subject to any discriminatory practice for example on the grounds of their gender, race, sexuality, disability or age..

People had their care visits as planned. Staff arrived on time and stayed for the allotted time. Nobody reported any missed visits. People confirmed there was a stable staff team and that care was provided by familiar faces. Staff told us that travel times were sufficient, so they were not rushed.

Care records were organised, detailed, and personalised. Th

Inspection carried out on 19 October 2015

During a routine inspection

Falcare is a domiciliary care agency that provides personal care and support to younger adults and older people in their own homes. At the time of our inspection 36 people were receiving a personal care service. Some people had short visits at key times of the day to help them get up in the morning, go to bed at night and give support with meals. Other people received longer visits to support them with their daily lives and other people received a 24 hour supported living service. A supported living service is one where people live in their own home and receive care and support to enable people to live independently. People have tenancy agreements with a landlord and receive their care and support from the domiciliary care agency.

There was 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.

We carried out this inspection on 19 October 2015. The service was last inspected in October 2013 and was found to be meeting the Regulations.

People we spoke with told us they felt safe using the service and said they trusted the staff who supported them. People said about the service, “They [staff] arrive on time” and “Good service - no problems”.

Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected. There were sufficient numbers of suitably qualified staff to meet the needs of people who used the service. The service currently had staff vacancies and these hours were being covered by the registered manager, the team leaders and existing care staff until new staff were recruited and ready to start working.

People were supported to take their medicines by staff who had been appropriately trained. People received care from staff who knew them well, and had the knowledge and skills to meet their needs. People told us staff always treated them respectfully and asked them how they wanted their care and support to be provided. People and their relatives spoke well of staff, comments included, “They [staff] look after me well”, “Staff are very good and helpful” and “Staff are kind to me”.

Care plans provided staff with clear direction and guidance about how to meet people’s individual needs and wishes. The service was flexible and responded to people’s needs. People told us about how well the service responded if they needed any changes to their hours. For example, the relative of one person told us how the service had split one of their duties into two shorter visits. This had been requested to give the person an additional visit to meet their needs and provide another safety check during the day.

People living in the supported living service told us staff supported them to access the local community and take part in activities of their choosing. Individual risk assessments for when people took part in activities detailed the action staff should take to minimise the chance of harm occurring, while still enabling them to be independent. A relative said, “The service has supported [person’s name] to work and socialise safely in the local community”.

The management had a clear understanding of the Mental Capacity Act 2005 and how to make sure people who did not have the mental capacity to make decisions for themselves had their legal rights protected. Where people did not have the capacity to make certain decisions the service acted in accordance with legal requirements. Where decisions had been made on a person’s behalf; the decision had been made in their ‘best interest’.

People said they would not hesitate in speaking with staff if they had any concerns. One person said, “I would tell them [staff] if I was unhappy about anything”. People knew how to make a formal complaint if they needed to but felt that issues would usually be resolved informally. A relative told us, “The manager is very approachable, she comes regularly to cover duties so any issues can be raised with her as they occur”.

There was a positive culture in the service, the management team provided strong leadership and led by example. Staff said, “Best company I have ever worked for, an amazing team”, “Management are easy to talk to, always make time for you” and “I am proud to work for them”.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. The registered manager and directors were visible in the service and regularly sought people’s views of using the service. One person told us, “The manager and one of the managing directors come to visit me regularly to ask me if I am happy with the service”.

Inspection carried out on 16 October 2013

During an inspection to make sure that the improvements required had been made

During this inspection visit we looked at the improvements made since our last inspection.

We saw the registered manager had developed a new template for person centred care plans. We saw an example of a new plan; information was clear and directed staff as to the care and support people needed. We saw a new way of writing person centred risk assessments had also been developed which gave staff clear guidance on risks and how to manage them.

Falcare had developed financial policies to ensure peoples’ monies were properly handled.

Inspection carried out on 19 June 2013

During a routine inspection

We spoke with six people who used the service or their representative, talked with three members of staff and the manager and looked at records of people who used the service.

People told us they got the same carers and they arrived on time. People said they liked the staff, one person said “They know me well”. A parent we contacted said they were "Satisfied that X is receiving a good standard of care and more importantly X appears to be happy with the support"

The systems in place to protect people from financial abuse were not robust.

We found staff had started to receive appropriate training and regular supervision. Staff felt supported. One person told us "I can talk to any of the managers about anything".

Systems were in place to monitor the quality of the service.

Records were not always in place or accurate.

Inspection carried out on 4 March 2013

During a routine inspection

We spoke with five people who used services or their representatives, talked with four staff and the manager and looked at records of people who used services.

People told us the staff who visited them were good timekeepers, that it was usually the same carers, and that the agency were “very flexible”. People were positive about the carers themselves saying they had no complaint about them as individuals or the care provided. People said they had confidence in the agency, and comments included: “very satisfied”, and “polite and professional”.

People told us the care provided met people's expectations and needs.

People were not fully protected from abuse.

People were protected from the risk of infection and from unsafe or unsuitable equipment.

The staff were not supported by training and supervision.

Systems for monitoring the quality of the service provided were not used.

Records were not always available, or accurate and did not demonstrate the service provided.