This first comprehensive inspection took place on 09 October 2017 and was announced.

Anchusa Care is registered to provide personal care for adults with learning and physical disabilities and older people, including people living with dementia who live in their own homes. At the time of our inspection there were 30 people using the service.

The service had a registered manager. 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.

People felt safe and were protected from the risk of avoidable harm. Staff were knowledgeable about the risks of abuse and there were suitable systems in place for recording, reporting and investigating incidents. Risks to people's safety had been assessed and staff used these to assist people to remain as independent as possible. There were sufficient safely recruited staff employed to meet the range of care and support needs of people who used the service. Medicines were administered, handled and recorded safely.

Staff had considerable knowledge about the needs of the people they cared for. They attended a variety of training to help keep their knowledge and skills up to date and were further supported with supervision by senior staff. People who used the service were actively encouraged to make their own decisions and staff followed the principles of the Mental Capacity Act 2005. People could make choices about their food and drink and were provided with support when required to prepare meals if this was an assessed part of their package of care. Prompt action was taken in response to illness or changes in people's physical and mental health and people were supported to access health care professionals when required.

People's experiences of care were overwhelmingly positive. They told us they were supported by kind and caring staff. People were at the centre of their care and we found clear evidence that their care and support was planned with them and not for them. There was a strong culture within the service of treating people with warmth, dignity and respect. The staff and the registered manager were always available and carefully listened to people and their representatives, offered them choices and always made them feel that they mattered.

People's needs were assessed prior to them being provided with care and support. People received a personalised service which met their individual needs. Care plans were detailed, person centred and updated on a regular basis, or as and when people's care needs changed. Changes in people's needs were quickly identified and their care packages amended accordingly. The service was flexible and any additional support was provided where necessary. People knew how to make a complaint and there was a complaints procedure in place which was accessible to all. Complaints had been responded to swiftly and robustly investigated in line with the provider’s complaints procedure.

People who used the service, their relatives, the staff team and an external social care professional gave us positive feedback about the way the service performed and all said this was due to the registered manager and their tireless passion for the service.

The registered manager demonstrated a clear understanding of the importance of effective governance processes. There were robust quality monitoring systems and processes in place to make positive changes, drive future improvement and identify where any action needed to be taken.

There was an open culture and the registered manager’s clear vision and values were clearly understood and embraced by the whole staff team. All staff members we spoke with told us they were very proud to work for the service and people who used the service and their rel