Future Care Solutions

care to adults living in their own homes. There were 41 people being supported with the regulated activity of personal care at the time of our inspection.

People’s experience of using this service:

People were at the very heart of the service and mattered. The provider's philosophy and values were shared across the staff team.

The providers and staff team were passionate about providing high quality care tailored to people's

individual needs and preferences. Staff invested time to get to know and appreciate the preferences and experiences of people who received a service.

Time was taken and invested in making sure that staff shared the values of the service and in matching them with the interests of the people they supported. Staff consistently respected people's privacy and dignity and people were supported to be as independent as possible.

The service was extremely well managed and people and their relatives consistently praised the passion and drive of the providers and their motivation to provide an exceptional service. People, their relatives and staff consistently told us they would positively recommend the service to other people.

Staff were especially kind and caring and had very good relationships and connections with people. They understood people's wishes and preferences and provided personalised care.

People felt very involved in their care, were asked for their views and felt that their opinions mattered. Individual’s care needs were very well known by the staff who were supporting them. People received care in a manner which was in accordance with the principles of the Mental Capacity Act 2005. People were given the information needed to make informed choices, and their choices were respected. Where required, people were supported with their meals to their liking.

Rating at last inspection: The service was rated ‘Outstanding’ at our last inspection in May 2016. The report following that inspection was published on 12 August 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

There was a registered manager in place during this inspection. A registered manager is a person who has registered with the Care Quality Commission (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 CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. No one being supported by the service lacked the mental capacity to make day-to-day decisions. Staff demonstrated to us that they respected people’s choices about how they would like to be supported. Staff were able to demonstrate a sufficiently robust understanding of MCA to make sure that any decisions made on people's behalf by staff, should people lack mental capacity would be in their best interest and as least restrictive as possible.

Records were in place for staff to monitor people’s assessed risks, support and care needs. Plans were put in place to minimise people’s identified risks and to assist people to live as safe a life as possible whilst supporting their independence.

Arrangements were in place to ensure that where needed people’s medicines were managed and administered safely. Accurate records regarding the administration of people’s prescribed medicines were kept.

Where people needed this support, people’s nutritional and hydration needs were met. People who required this assistance were supported to access a range of external healthcare professionals to maintain their health and well-being.

People were supported by staff in a kind and respectful manner. People’s care and support plans gave guidance to staff on any individual assistance a person required. Records included how people wished to be supported, and what was important to them. These records and reviews of these, documented that people and/or their appropriate relatives had been involved in this process.

Staff understood their responsibility to report any poor care practice or suspicions of harm. There were pre-employment safety checks in place to ensure that all new staff were deemed suitable and safe to work with the people they supported. There was a sufficient number of staff to provide people with safe support and care.

Staff were trained to provide care and support which met people’s individual needs. The standard of staff members’ work performance was reviewed during supervisions, ‘job chats’ [appraisals] and competency checks to make sure that staff were competent and confident to provide care and support.

The registered manager sought feedback about the quality of the service provided from people and their relatives. People felt listened to and they were able to raise any suggestions or concerns that they had with the registered manager and staff.

Staff surveys were opportunities for staff to feedback their experiences. Staff meetings also took place. Staff were encouraged to raise any concerns or suggestions that they may have had at this meeting and felt listened to. Staff knew the values of the service and service values were embedded.

There were effective and robust quality monitoring systems in place to review and monitor the quality of the service provided and to implement continual improvement. The registered manager had been nominated for national award schemes for their work.

As part of this inspection we spoke with seven people who used the agency, three relatives, the manager, office based staff, four members of care staff and two healthcare professionals who had contact with the agency. We reviewed records relating to the management of the service which included: five care plans, daily records, safeguarding records, training and supervision records and quality assurance monitoring records.

Below is a summary of what we found. The summary describes what people who used the agency, their relatives and the staff told us, what we observed and the records we looked at.

Is the service caring?

The agency provided care and support for people living in their own homes. People told us that they received consistent and respectful support from care staff and felt able to make choices and changes to their care when necessary. Relatives that we spoke with made positive comments about the care and support provided to their family members. Care staff told us that they were well supported and supervised so that they could provide safe care and support to people. Courtesy calls were made to people using the agency and their relatives to discuss any care and support issues.

Is the service responsive?

We saw that people's personal care and support needs were assessed and met. This also included people's individual choices and preferences as to how they wanted their care to be provided. People we spoke with told us that they had been able to make changes to their support and had been involved in reviews of their care. Relatives that we spoke with also confirmed that they had been involved in reviews. We saw that changes to documentation were made to ensure that care and support being provided was up to date and met people's needs.

Is the service safe?

Risk assessments regarding people's individual needs were carried out and measures were in place to minimise any identified hazards. Care staff understood their roles and responsibilities in making sure that people were protected from the risk of abuse. We saw that the provider was taking appropriate action to ensure that all care workers had received safeguarding training to ensure peoples' safety. There were effective arrangements in place to ensure that staff were well trained and supervised so that they could safely provide care and support to people.

Is the service effective?

We found that care workers were knowledgeable about people's individual care and support needs. People who used the agency that we spoke with, and their relatives, confirmed that care staff provided consistent care and support and were keen to address any concerns or issues. The service manager confirmed that regular reviews of care and support were in place to meet people's assessed needs.

Is the service well led?

The agency had a registered manager. Staff that we spoke with told us that they felt well supported by the management team so that they could safely provide care and support. People and their relatives that we spoke with told us that they felt they were listened to and that support was consistently and safely provided. Quality assurance systems were in place to regularly audit the care and services provided. Surveys were carried out to gather opinions from people who used the agency. The manager and care staff were in daily contact with people and their relatives to respond to their concerns or queries.

We found that the provider was compliant with the regulations in all the areas we assessed. If you wish to see the evidence supporting our summary please read the full report.

There were procedures in place to ensure that medicines were safely administered and recorded. Staff received ongoing medication training and undertook competency tests to ensure their practice was monitored.

There were effective recruitment procedures in place which ensured that all appropriate checks had been made prior to staff starting work. There was an induction programme in place for new staff and mandatory training was provided to ensure they were competent to deliver care.

Quality assurance procedures were in place for monitoring the running of the agency and people using the service were able to raise any issues and concerns with the management team.