Staying at Home Care

This service is a domiciliary care agency. It provides personal care to older adults and younger disabled adults living in their own homes. There were 30 people using the agency at the time of our inspection, 16 of whom received personal care. The registered provider of the service is Mr Ben Maynard, referred to in this report as 'the provider' and a manager was employed to run the agency.

At our last inspection in March 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. The rating for the Responsive domain has improved to Outstanding.

Why the service is rated Good.

People received a service that was highly personalised and exceptionally responsive to their needs. They could rely on receiving the care they needed even if their plans changed at short notice or in an emergency. We heard many examples of the manager, the provider and staff responding quickly to keep people safe and secure when adverse events had occurred. Relatives told us they agency's response to these events had been crucial in preventing harm and anxiety. All the people and relatives we spoke with said the agency had greatly exceeded their expectations in terms of its responsiveness.

People felt safe and secure when staff provided their care. Staff were trained to provide the support people needed safely and to use any equipment involved in their care. Any risks involved in people's care were identified through assessment and action taken to minimise them.

Medicines were managed safely and equipment used in providing people's care was serviced regularly to ensure it was safe for use. Staff helped people keep their homes safe and clean and maintained appropriate standards of infection control. The provider had a plan in place to ensure people's care would not be interrupted in the event of an emergency.

People were protected by the provider's recruitment procedures and staff were aware of their responsibilities should they suspect abuse was taking place.

Staff had the induction, training and support they needed to perform their roles. All staff had an induction when they started work and ongoing training relevant to the needs of the people they cared for. Staff attended regular one-to-one supervision with the manager, which gave them the opportunity to discuss their training and development needs.

People's needs were assessed before they began to use the agency and kept under review. People were

supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff monitored people's health and supported them to obtain treatment if they needed it.

Staff were kind and caring. They treated people with respect and maintained their dignity when providing their care. Staff supported people to maintain their independence where this was important to them. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The manager, provider and staff had developed effective working relationships with other professionals involved in people's care. This included specialist healthcare professionals to ensure people received the care they needed towards the end of their lives. The manager and provider planned and co-ordinated one person's end-of-life care as their family did not live nearby. The manager and provider ensured the person was as involved as possible in making decisions about their care and adapted the care the person received at each stage of their life.

People and their relatives were encouraged to give feedback about the agency and this was acted upon. The manager and manager knew all the people who received care from the agency personally and maintained regular contact with them. People told us this meant any issues they raised were resolved before they became concerns.

The manager and provider maintained an effective oversight of the service and the quality of care people received. They provided good support to people who used the service and their families and effective leadership for staff. The manager ensured that staff had access to the training they needed and responded well if staff requested additional support.

Further information is in the detailed findings below.

The five questions we ask about services and what we found