The inspection took place on 15 October 2015 and was announced. This was the first time we have inspected this service

The service provided domiciliary care to nine people in their own homes. There had not been a registered manager in place since April 2015 however we saw that a new manager was currently in the process of registering with the Commission. 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.

People told us that they felt the service kept them safe. Staff were aware of how to protect people from the risk of harm and how to raise these concerns when necessary. The provider managed risks to people in order to protect them from harm. The regional manager had plans to review people's risk assessments in the near future. After our inspection we were notified that the provider had produced a series of guidance for staff about how to manage the risks associated with people’s specific conditions.

There were enough staff to keep people safe and to meet their needs. People confirmed that they were always supported by the number of staff identified as necessary in their care plans. The provider had established a resource of bank staff who were employed to provide occasional cover when regular staff are unavailable] who they could call upon to support people at short notice. Staff told us that they had undergone robust checks to ensure they could support people safely but this was not always evidenced by the provider.

People who required assistance to take their medication said they were happy with how they were supported. Staff were able to explain how they supported people to take their medication in line with their care plans.

Staff had the skills and knowledge they needed to meet people’s care needs. Staff received regular observations of their practice and supervisions to ensure they remained competent to support people in line with their care plans and best practice.

People had been asked how they wanted to be supported and when necessary they had been supported by others who were close to them in order to help express their views. We saw that the provider had ensured people were supported in line with these wishes.

The provider had conducted assessments of people’s capacity to make every day decisions.

People told us that staff supported them to eat and drink enough to stay well. Staff knew what people liked to eat. People had access to other health care professionals when necessary to maintain their health.

All the people we spoke with said that staff were caring and were happy to be supported by the service. People had developed positive relationships with the staff who supported them and spoke about them with affection. The service promoted people’s privacy and dignity.

People told us the service would respond appropriately if their needs and views changed. We saw that records were updated to reflect their views. Records contained details of people’s life histories and who they wanted to maintain relationships with so that staff could provide the support people wished.

The provider had systems in place to support people to express their views about the service and People were aware of the provider’s complaints process. People felt their concerns were sorted out quickly without the need to resort to the formal process.

People we spoke with said they were pleased with how the service was managed and felt involved in directing how their care was developed.

A new regional manager had recently joined the service and was currently in the process of registering with the Commission. They understood the responsibilities of their role. The regional manager had clear views of the actions they wanted to take to improve the service and staff we spoke with were confident in their abilities to lead the service.

The provider had processes for monitoring and improving the quality of the care people received which included observational audits of how staff provided care to people in their own homes. When necessary they had taken action in order to improve the quality of the care provided by specific members of staff.