Emmaculate Care Services Selby Office

Not everyone using Emmaculate Care Services Selby Office receives regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Inspection activity started on 14 June 2018 and ended on 27 June 2018. It included telephone calls to people who used the service and their relatives or carers. We visited the office location on 18 and 27 June 2018 to see the registered manager and office staff; and to review care records and policies and procedures. The provider was given five days' notice of our inspection, because the location provides a domiciliary care service and we needed to be sure that someone would be in the location's office when we visited. At the time of our inspection, there were 19 mainly older people using the service.

At the last inspection in April 2017, records were not always well maintained and effective systems were not in place to monitor and audit the quality and safety of the service. We rated the service requires improvement overall and identified one breach of regulation relating to the governance of the service. We asked the provider to take action to address our concerns. At this inspection, improvements had been made and we rated the service 'Good' overall.

Risk assessments did not always contain clear and detailed information about how staff should manage risks to keep people safe. It is important that risk assessments provide clear and detailed information to support staff to provide consistently safe care.

Staff supported people to take their prescribed medicines. The provider had not followed their own policy and procedure, as sufficiently detailed protocols were not always in place to guide staff on when to administer medicines prescribed to be taken 'as required', such as pain relief. It is important staff have information about when to administer these medicines to ensure they are given safely and appropriately.

Improvements had been made to how staff training, supervision and appraisals were evidenced. Staff completed a range of training courses to support them to provide effective care. The registered manager documented observations and competency checks to monitor the support they provided and support staff to continually improve and develop. Staff received regular supervision and an appraisal of their performance. People gave positive feedback about the skills and experience of the staff who supported them.

Consent to care was recorded. Staff documented mental capacity assessments. We spoke with the registered manager about making sure they recorded the specific decision for which people's mental capacity was being assessed. Staff supported people to make sure people ate and drank enough. They helped people to access healthcare services if they were unwell or needed medical attention.

Staff were trained to recognise and respond to safeguarding concerns. The provider safely recruited new staff. Enough staff were deployed to meet people's needs. People told us staff were reliable and punctual. Systems were in place to minimise the risk of spreading infections.

People praised the attitude and friendliness of staff and complimented their kind, caring and respectful approach. People told us staff listened to them, treated them with dignity and respected their decisions.

Staff provided person-centred care and responded to people's needs. People told us they felt able to raise issues or concerns and confident management would respond and act on their feedback.

The service had a registered manager. They had been the registered manager since October 2016. A registered manager is a person who has registered with the CQC 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. The registered manager was supported by a business manager, deputy manager, care coordinators, a field supervisor and quality monitoring lead in the management of the service.

People who used the service and relatives gave overwhelmingly positive feedback about the quality of the care and support provided. Staff told us management were approachable and supportive. We made a recommendation about continuing to develop audits to monitor all aspects of the service.

The five questions we ask about services and what we found