Above & Beyond Care Ltd Also known as Above and Beyond Care Limited

At our last inspection of 12 April 2016, the service was rated good overall. The key questions for safe, effective, responsive and well-led were rated good and the key question caring was rated outstanding. At this inspection we found the evidence continued to support the rating of good overall and the rating of outstanding in caring. 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.

The service continued to provide an extremely caring service. Without exception, people had very positive relationships with their care workers. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued and as a result they were provided with a very personalised service which met their needs and preferences.

The service continued to provide people with a safe service. Risks to people continued to be managed well, including risks from abuse and in their daily lives. The service learned from incidents to improve the service. There were enough care workers to cover people’s planned care visits. Recruitment of care workers was done safely. Where people required support with their medicines, this was done safely. There were infection control procedures in place to guide care workers in how to minimise the risks of cross infection.

The service continued to provide people with an effective service. People were supported by care workers who were trained and supported to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Systems were in place to support people with their dietary needs, if required. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

The service continued to provide people with a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people at the end of their lives, where required. A complaints procedure was in place.

The service continued to provide a well-led service. The service used comments from people and care workers to drive improvement. The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve.

Further information is in the detailed findings below.

The service had a registered manager in place who was also the owner. 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.’

Throughout the inspection we consulted people who used the service and where appropriate, their

representatives. The feedback we received from people was excellent. People who used the service expressed great satisfaction and spoke very highly of the service.

Staff had a full understanding of people’s care needs and had the skills and knowledge to meet them. They used this knowledge to provide care and support which responded to the needs of the individual. People received consistent support from care workers who knew them well

People were fully involved in their care planning and were fully consulted about what they required before care and support started and at regular intervals thereafter. Care plans contained risk assessments which ensured that risks to people’s safety and wellbeing were identified and

addressed.

People had positive relationships with their care workers and were confident in the service. There was a strong emphasis on key principles of care such as compassion, respect and dignity. People felt they were treated with kindness and said their privacy and dignity was always respected.

The service was flexible and responded positively to people’s requests. People who used the service felt able to make requests and express their opinions and views. The manager was committed to continuous improvement and feedback from people, whether positive or negative, was used as an opportunity for improvement. The manager also demonstrated strong values and a desire to learn about and implement best practice throughout the service.

The management team demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. Where these processes identified areas for improvement these were addressed appropriately.

Staff were highly motivated and proud of the service. They described a ‘supportive’ and ‘open’ working environment within which they were encouraged to express concerns and share their views and opinions.

We saw that people had an assessment of their needs and had care plans in place so that staff knew what the needs of the individual people they supported were. One person said, 'Without those carers I would have been lost. They assessed my needs and have reviewed my care plans. They see what I need and do what I need.'

There was evidence that new staff received an induction which included theoretical and practical training. We looked at three staff files and there was evidence of completed mandatory training. We spoke with three members of staff who said that they felt supported by their manager.

We saw evidence that the provider obtained the views of people who used the service and had recently sent out a quality assurance questionnaire for people to complete. One person said, "I can't really fault the service. If there is anything wrong, then I tell them and they put things right straight away."

The provider made people aware of the complaints policy and people we spoke with confirmed this. The registered manager said, "If there is an issue then I will try and resolve it.' The provider had not received any complaints and they did have a process in place to respond to a complaint.

People we spoke with felt involved in planning their care package. One person said "The manager came at the beginning and we discussed what I needed."

Care plans were inspected and found to be fully documented with personal details, community care assessments, times of care visits and care needs, client assessment form, risk assessments, care plans and care worker visit reports.