This inspection took place on 6 September 2016 and was announced. It was carried out by one adult social care inspector. We gave the provider short notice of the inspection as we needed to make sure they were available so that we were able to access records, talk to staff and gain permission from people who used the agency to talk to them.

Blue Moon Care provides support and assistance with personal care to people who live in their own home. The agency provides a small bespoke service to two people who suffer with Myalgic Encephalopathy, also known as Myalgic Encephalomyelitis (ME). ME is characterised by a range of neurological symptoms and signs, muscle pain with intense physical or mental exhaustion, relapses, and specific cognitive disabilities.

At our last inspection of the service in April 2014 we did not identify any concerns with the care provided to people.

At the time of our inspection there were two 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 service demonstrated a very strong and visible person centred culture and they were committed to providing a service which put people at the heart of everything they did. The agency was set up with and for the two people who used the service. The agency employed a small team of five staff; many of whom had worked for the agency since its registration in 2012 this meant they had got to know people very well. A person who used the service described the staff as “kind and very friendly.”

The agency was committed to enabling the people who used the service to live fulfilling lives and supported them to achieve their goals. For example one person was being supported to work towards a master’s degree. Another person was supported to complete a computer course which meant they could join in with interactive staff training sessions. The person also enjoyed supporting a member of staff, whose first language was not English, to complete their on-line training sessions. Another person who used the service was working towards a career they could conduct from their own home.

People were supported to follow a wellbeing programme. Staff supported people to care for their pets. Both people were keen gardeners and staff supported them to grow produce which they regularly exhibited at the Taunton Flower Show. Both people who used the service were involved in the agency’s ME Uncut project which was set up by the registered manager and both people to raise awareness of ME. The registered manager and the person we met with told us how, when exhibiting their produce at the Taunton Flower show, they had created cards for the public which gave brief information about ME to raise awareness of the illness.

People’s views were valued and responded to. For example, one person identified a training need for staff and this was arranged. A person who used the service explained how they were involved in the recruitment of staff. They said “I go through the application forms and help to decide who to short list. I then interview the staff with [name of registered manager.]” The registered manager told us “It’s down to our clients who we employ.”

Care was planned and delivered in a way that was personalised to each person. Staff monitored people’s healthcare needs and, where changes in needs were identified, care was adjusted to make sure people continued to receive care which met their needs and supported their independence.

Staff were well trained and people were confident they had the skills to meet their needs. One person said “I have a regular carer who is just brilliant. She really knows what she is doing. She knows what needs to be d

We inspected the service at short notice on 23 April 2014 and found that the agency provided a specialist service for two people with Myalgic Encephalomyelitis (ME). We spoke with both people who received the service and also with the provider/registered manager and four members of staff.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led? This is a summary of what we found.

Is the service safe?

We found that a flexible, specialist service, individually tailored to people's care needs was provided. People were treated with dignity and respect by the staff and people told us they felt safe. There were systems, policies and procedures in place which ensured risks to people were reduced and that the service was safe.

Risk assessments had been undertaken and people were given choice and options about how their care and support was provided. People remained in control of decisions about their care and lives.

Policies and procedures in operation were comprehensive and ensured that risk was reduced, unsafe practice was identified and people were protected. A strong emphasis on training ensured that staff were competent and knowledgeable in their roles.

Is the service effective?

Both people who received a service were involved in the development of their care plan. We examined care plans which were clear in explaining what care and support was needed. Daily task sheets records were detailed and up to date which showed us that staff provided the appropriate care and support specified in the care plan.

Is the service caring?

We spoke with both people who received a service about the care they received. They told us they were involved in every aspect of their care. Staff we spoke with respected people’s decisions and gave people options and choice. People were not rushed. Staff said they was always time to talk with people. We observed friendly, caring relationships between people and the staff who knew each other well.

Is the service responsive?

The agency was small and able to respond immediately to any request by the person for a change in their care. People and staff told us that everyone worked together closely. People who received care were involved in all aspects of the operation of the agency and were fully consulted at every stage. People told us the service was constantly being improved and that if anyone had an idea for improvement it would be tried. We observed open easy communications between everyone involved with the agency.

People were aware of the complaints procedure but no one had any complaint. People told us they had no hesitation raising any issue if there was ever a concern.

Is the service well led?

The agency had formal systems in place to monitor the quality of the service provided. There was a clear management structure in place and lines of accountability were clear. Staff had a good understanding of the ethos of the agency and to quality processes in place. The provider who was also the registered manager was actively involved in the day to day operation of the service and committed, alongside other staff to the continuous improvement of the service.

Blue Moon provided care for two people who suffered from Myalgic Encephalomyelitis (ME).

During this inspection we visited the agency office; we spoke with the two people the agency provided care and support for. We also spoke with a care worker, the deputy manager and the registered manager/provider.

Both people spoken with told us they felt the care provided was relevant to their needs. One person told us, “I am always involved and if I want things done differently they always listen “.

We found people were involved in all areas of their care. From developing and agreeing their care plans to being involved in staff training and recruitment.

We saw care plans were person centred and included clear guidance for care workers about specific needs.

People told us they felt safe using the service and knew who to speak to if they had concerns.

Staff told us they received relevant training which was specific to the care needs of the people they looked after.

The provider had an effective system in place to assess and monitor the quality of service provided.