The inspection took place on the 18, 19 and 21 September 2018 and was announced. The provider was given 48 hours’ notice because the location provides a care at home service. We wanted to be sure that someone would be in to speak with us.

Better Healthcare Services (Brighton) is a domiciliary care agency. It provides personal care to people living in their own homes in the community and provides a service to adults. On the day of the inspection the service was supporting approximately 140 people with a range of health and social care needs, such as people with a physical disability, mental health issues, sensory impairment or people living with dementia. Support was tailored according to people’s assessed needs within the context of people’s individual preferences and lifestyles to help people to live and maintain independent lives and remain in their homes. Not everyone using Better Healthcare Services (Brighton) receives a regulated activity; 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.

This service was registered by CQC on 13 September 2017, due to a change in the legal entity, however the management and staff remain the same as the previous registration. Better Healthcare Services (Brighton) has not been previously inspected under their current registration.

The service had a registered manager. 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.

Outstanding, person centred and innovative training resources equipped staff with the skills, knowledge and understanding to meet the challenges of supporting people with diverse and complex needs. Bespoke training had been developed to ensure that people remained safe and had their health and wellbeing protected at all times. This increased the overall skills of the staff team which complemented the delivery of high quality care. There was a culture of embracing learning and development within the service. People and their relatives felt confident in the skills of the staff and they received effective care that met their needs.

Sufficient staff were available to ensure people's wellbeing and safety was protected. A robust recruitment and selection process was also in place.

Staff had a good understanding of systems in place to manage medicines. People were supported to receive their medicines safely. Staff considered people’s capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were kind and caring and had developed good relationships with people. People told us they were comfortable in the presence of staff. They confirmed the staff were caring and looked after them well. People were provided with the care, support and equipment they needed to stay independent in their homes.

People were provided with information and guidance to access other services which were relevant to them for any on-going support. People’s individual needs were assessed and detailed care plans were developed to identify what care and support they required. People were consulted about their care to ensure wishes and preferences were met.

Quality assurance and information governance systems were in place to monitor the quality and safety of the service. People and relatives all told us that they were happy with the service provided and the way it was managed. Social activities and event