We inspected this service on 17 September 2018. The inspection was announced. The service is a domiciliary care agency. It provided personal care to people living in their own houses and flats in the community. The service is for older adults, including people living with dementia and people needing care at the end of their life.

The service was registered with the Care Quality Commission to provide regulated personal care in September 2017. This was their first inspection. At the time of the inspection, eight people were receiving personal care and support from this service. Some people were supported with a ‘live-in’ carer.

There was a registered manager in post. 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 2008 and associated Regulations about how the service is run.

There were sufficient staff to deliver all the care hours that were needed by people. The service was developing incrementally as new care staff were employed. There were safe recruitment practices in place and a service goal to always employ the right staff.

People were kept safe from abuse because there were safeguarding procedures in place and staff were aware of potential harm and knew how to report it. Risks to people in their homes were identified at the outset and kept under review. There were plans in place to reduce risks and staff knew about the actions to take. Incidents and accidents that did occur were recorded and reviewed, and learning was discussed with staff.

Where people were assisted to take their medicines, this was done safely. Staff were trained to administer medicines. There were weekly medicines checks in place. Staff followed safe practice to reduce the spread of infections and kept people’s homes clean.

People received an assessment in line with good practice before any service was provided. This was completed thoroughly with the person and their family.

Staff had received a good induction and training before beginning their role. They shadowed a more experienced care worker in the home and given instructions on any equipment, special requirements or communication needs that the person had. Staff were supervised regularly and felt able to ask for support and advice at any time.

The service worked with other agencies to meet people’s specific needs. Staff worked together and fed back to the registered manager any issues that needed to be addressed. People were enabled to access health and social care specialists and this improved the outcomes for people’s health and well-being.

People’s consent was sought in line with the principles of the Mental Capacity Act 2005. Staff were aware of their responsibilities and diligent in recording that consent was given before giving any care.

The care staff treated people with kindness and compassion. Staff had enough time to provide good care in a calm manner and to involve people in the way they liked. People’s privacy was maintained and their independence was promoted. People told us they felt that they mattered to the staff and personal interest was taken in them. People’s homes and belongings were respected and looked after by staff. The service was trusted by the people it supported.

People received care in a personal way that suited them. As far as possible, the timing of calls and choice of care worker was met. People’s preferences were understood and there was a responsive approach to meeting individual requests.

People’s concerns were responded to personally. People knew how to complain but there had been no formal complaints.

End of life care was provided by the service. Staff worked with other agencies to provide a dignified and comfortable experience for people. Relatives had fed back how pleased they were with the care given.

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