3HA is a domiciliary care agency (DCA) which provides care and support to people in their own homes. At the time of our inspection there were 29 people using the service.

The inspection was announced and took place on 21 June 2017. 48 hours' notice of the inspection was given because we needed to be sure that the registered manager would be available.

At the time of inspection there was a registered manager in post who was also the registered provider. 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 and associated Regulations about how the service is run.

Staff had received training in how to protect people from the risk of harm so people received care and support from staff who understood their safeguarding responsibilities. Staff recognised the different signs of abuse and knew what action to take if they suspected abuse had occurred.

The service had assessed risks to people and management plans were in place which provided guidance to staff on how to prevent or minimise the risk of people coming to harm.

Those people who required support with medicines were assisted by staff who had been trained and assessed as competent to give medicines safely.

There were sufficient numbers of staff employed who had been recruited safely.

New staff received an induction when they joined the service which included access to training to equip them with the knowledge and skills to care and support people effectively. Supervision and spot checks were completed regularly to continuously monitor and assess staff competency and performance.

The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The legal requirements of the Mental Capacity Act 2005 (MCA) were followed when people were unable to make specific decisions about their care. Staff had received training in the MCA and understood how to help people to make their own decisions.

Where people required assistance at mealtimes, they were supported by staff to have enough to eat and drink which met their preferences and health needs. The service worked with health and social care professionals when they had concerns about people's health and safety so that people received the support required to maintain their health and wellbeing.

Staff were kind and caring and listened to people providing care and support how people wanted. People were treated with dignity and respect and encouraged to be as independent as they could be.

The care and support provided was tailored to meet people's individual needs in accordance with their wishes and preferences. People were supported by regular and consistent staff who knew people well and had formed positive relationships with them.

People had care plans which detailed how they wished to be supported. People were involved in the care planning process and in decisions about their care and treatment.

There were systems in place to support people to make a complaint or raise concerns about the service. Feedback from people who used the service was actively sought to improve the service.

Staff liked working at the service and felt well supported by the provider and the management team who were accessible as they were hands-on providing direct care and support to people.

People and staff were included in the running of the service and there were systems in place to monitor quality and safety and drive improvements.