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Inspection carried out on 25 June 2019

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

About the service:

The Angels on Call is a domiciliary care service. It is registered to provide personal care to people living in their own homes in the community, including older people and people living with dementia. The service operates in Boston and surrounding villages. At the time of our inspection, 16 people were receiving a personal care service.

Rating at last inspection:

Good (Published June 2018)

Why we inspected:

We conducted this inspection in response to information we had received which alleged people were at risk of receiving unsafe care; that the personal safety of staff was at risk and that there were shortfalls in the management of the service. Reflecting the information received, we inspected the service against elements of two of the five questions we ask about services: is the service Safe and is the service Well-led. None of the information we had received related to the remaining key questions so we did not inspect them. The ratings from the previous comprehensive inspection for these key questions were included in calculating the overall rating in this inspection.

At this inspection we found no evidence to support the allegations we had received. As a result, the rating of the service remains Good overall.

People’s experience of using this service:

Everyone we spoke with said they felt safe using the service and that the owner and her staff team were committed to promoting their safety and welfare. Similarly, staff told us they enjoyed their work and had no concerns about their personal safety.

Almost everyone we spoke with told us how highly they thought of the service and the way it was managed.

Safeguards implemented by the owner following our last inspection remained in place and were effective in mitigating a very specific potential risk to service users and staff.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 17 May 2018

During a routine inspection

The Angels on Call is a domiciliary care agency. The service was first registered with the Care Quality Commission (CQC) in November 2016 and had been operating for about eighteen months at the time of our inspection. The service is registered to provide personal care to people living in their own homes in the community, including older people and people living with dementia.

We inspected the service on 17 May 2018. The inspection was announced. At the time of our inspection 14 people were receiving a personal care service.

The service was managed on a full-time basis by the owner who worked in the service on a daily basis, both in the office and delivering care. The owner was the registered provider (‘the provider’) with legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Almost everyone we spoke with told us that they were highly satisfied with every aspect of the service they received. In particular, the provider’s careful approach to managing staffing resources which meant staff were rarely late for the start of their care calls. Staff had established warm, friendly relationships with people and went out of their way to help them in any way they could. Staff worked together in a supportive way. They were proud to work for the service and felt appreciated by the provider.

People were involved in agreeing the type and amount of care they received and their needs and wishes were understood and followed by staff. Staff treated people with dignity and respect and encouraged them to maintain their independence. Staff had the knowledge and skills required to meet people’s individual needs effectively and supported them to prepare food and drink of their choice.

People’s medicines were managed safely and staff worked closely with local healthcare services to support people to access any specialist support they needed. The provider assessed any potential risks to people’s safety and welfare and put preventive measures in place where required. Staff knew how to recognise and report any concerns to keep people safe from harm. Significant incidents were reviewed by the provider to identify opportunities for organisational learning.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. Staff understood the principles of the MCA and how to support people who lacked the capacity to make some decisions for themselves.

The provider was committed to the continuous improvement of the service and monitored service quality closely. The provider sought people’s opinions through customer surveys and people were confident any complaints would be handled properly.