This comprehensive inspection took place on 13 September 2018 and was announced. The registered provider was given short notice of our inspection. We did this because the service is small and the manager was sometimes out of the office and we needed to be sure that they would be available. This was our first inspection of the service.

Bespoke Care is a small domiciliary care service registered to provide personal care for people living in their own homes in the community. At time of the inspection the service was providing a home care service to seven people. It provides a service to older people, people living with dementia, mental illness or physical disability and people with learning disabilities or autistic spectrum disorder.

There was a manager at the service who was registered with CQC. 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.

We saw there were sufficient staff to provide regular care workers to people using the service. People received care from the same group of care workers. The person we spoke with was satisfied with the quality of care they received and made positive comments about the staff.

Relatives we spoke with were very satisfied with the quality of care their family member received. Relatives also made positive comments about the staff and the senior managers.

Care plans were detailed and person centred. People’s preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. Care plans were reviewed regularly and changed to reflect current needs.

Staff had undertaken safeguarding training and so they understood their role and responsibilities in keeping people safe from harm.

We saw people were cared for by suitably qualified staff who had been assessed as safe to work with people.

The service had appropriate arrangements in place to manage medicines so people were protected from the risks associated with medicines.

People had risk assessments in place, to ensure that potential risks to people were managed and minimised whilst still promoting independence.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Staff underwent an induction and shadowing period prior to commencing work, and had regular updates to their training to ensure they had the skills and knowledge to carry out their roles. Staff were well supported and received supervisions regularly.

We found the service had responded to people’s and/or their representative’s concerns and taken action to address any concerns.

The leadership and culture of the service promoted the delivery of high quality care.

People and relatives spoke highly of the staff, the registered manager, the nominated individual and the service as a whole.

There were quality assurance systems in place to monitor the quality and the safety of the service provided.

The service sought the views of people and their representatives to continuously improve the service.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations.