Balkerne Gardens Trust Care At Home provides personal care to people living in the local community. The service provides personal care support to people aged over 65 years of age, living in their own homes. The usual minimum length of a visit is for an hour. When we inspected on 19 and 23 December 2016 there were 53 people using the service.

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.

The registered manager provided exceptionally strong, clear leadership and ensured an enabling and person centred culture was firmly embedded in the service. People, relatives, stakeholders and staff spoke very highly of the leadership of the service, and held the registered manager and provider in high regard. In the two years since the service has been established, there was a clear commitment to putting people at the heart of the service. People using and working for the service were empowered to provide their feedback of the service provided and this was used to promote continuous improvement. The service was committed to ‘putting the person first,’ and working in partnership with them, this approach underpinned everything they did.

People told us they felt safe and trusted the care workers who came into their home. They were protected from the risk of harm, as management and care workers had undertaken training to recognise, respond and report safeguarding concerns. They felt confident to speak up if they had concerns which ensured referrals were made promptly to the appropriate professionals. Risks associated with care workers providing, and people receiving care and support in their own homes, were also well managed. This demonstrated effective oversight of potential or actual risks to people using and providing the service.

People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were sufficient numbers of care workers to provide safe care. People were complimentary about care worker’s timekeeping and the quality of the caring and friendly care workers. People were cared for by care workers who were safely recruited, inducted, supported, supervised, and appraised. Care workers received training in core skills to support them providing a safe service. The registered manager and management team kept up to date with models of positive care and shared the information with the rest of the team to promote good quality care. They observed care workers in their duties to identify areas of good practice and areas for development. The vision of the service was shared by the motivated staff team and put into practice.

People received care and support which was responsive to their physical and mental health needs, rights, wishes and preferences. People, or their representatives, where appropriate, participated in the planning of their care. Care plans provided detailed information about the person and how they wanted to be supported. This ensured that people were supported as individuals and encouraged to maintain their independence in ways that were important to them. Where required, people were given the level of support they needed to ensure they took their medicines as prescribed and supported to have enough to eat and drink. Where care workers had identified concerns in people’s wellbeing appropriate prompt action was taken to contact other health and social care professionals to support people’s wellbeing.

There was a deep level of understanding of the impact of having robust and effective quality assurance systems which led to service improvements and