The inspection took place on 17 April 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults, including people living with dementia, and younger adults who may have needs related to a physical or learning disability. There were 99 people using the service at the time the provider returned their provider information return (PIR) on 8 February 2018, 12 of whom were receiving live-in care.

Not everyone using the service received the regulated activity personal care. CQC only inspects the service being received by people provided with personal care; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post at the time of our inspection. Like registered providers, registered managers 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 provided people’s care in a safe way. They understood any risks involved in people’s care and managed these well. People felt safe when staff provided their care and said staff used any equipment involved in their care safely.

There were enough staff employed to meet the agency’s care commitments. The provider carried out checks to ensure they employed only suitable staff. Staff attended safeguarding training and understood their responsibilities in terms of recognising and reporting abuse.

The provider had made plans to ensure people’s care would not be interrupted in an emergency. If an incident or accident occurred, this was recorded and checked to identify what action could be taken to prevent a recurrence. Action had been taken to improve when people had experienced poor care.

Staff maintained appropriate standards of infection control. Where people received support with their medicines, this was managed safely.

People’s needs were assessed before they used the service to ensure the agency could meet their needs. People were encouraged to contribute to their assessment to ensure they agency understood their needs and preferences.

Staff had access to the training and support they needed to do their jobs. All staff attended an induction which included all elements of mandatory training and shadowing colleagues to understand how people preferred their care to be provided. Staff had access to regular refresher training and training relevant to the needs of the people they cared for. Staff had opportunities to speak with their managers about their performance and training and development needs.

People’s care was provided in accordance with the Mental Capacity Act 2005. Staff understood the importance of consent and respected people’s choices about their care. If people lacked the capacity to make decisions, relevant people had been consulted to ensure any decisions were made in the person’s best interests.

The agency worked effectively with other professionals when people moved between services, working closely with local hospitals regarding planned discharges to ensure people’s transition from hospital to home was well managed.

Staff monitored people’s healthcare needs and responded appropriately if their health deteriorated. Staff accompanied some people to healthcare appointments and communicated with healthcare professionals where people wished them to do so.

People’s nutritional needs were assessed when they began to use the service. A care plan was developed to meet any identified dietary needs and specialist professional input obtained where necessary.

Staff were kind and caring. People received their care from regular staff who knew them well. People told us they had developed positive relationships with their care workers and enjoyed their company. Relatives said staff treated their family members with respect