Carewatch North West Wiltshire is a domiciliary care agency. Personal care is provided to people living in their own homes and flats in the community and specialist housing. It provides a service to mostly older adults as well as younger people with autism and with learning disabilities. Not everyone using Carewatch North West Wiltshire received the 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 is the first inspection for this service since the name of the agency changed and the location moved. It was announced and took place over three days. We visited the agency office on the 14 February 2018. We spoke with people and staff on the 16 February and 19 February 2018.

A registered manager was 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.

People told us the staff recorded the delivery of care and there were six monthly reviews. Care plans were person centred. Customer detail reports gave staff a summary of people’s preferred routines, the assistance needed from the staff and aspects of care they were able to manage for themselves. However, some parts of the care plans lacked detail. We recommend that the service seek advice and guidance from a reputable source, about developing clear and concise care plans.

The people we spoke with and who replied through questionnaires said they felt safe with the staff. Relatives said their family members were safe with the staff. The staff we spoke with and training records confirmed they had attended safeguarding of abuse training. They knew how to identify abuse and the procedures for reporting their concerns.

Risks were assessed and action plans were developed on minimising the risks. Individual risks to people included mobility, pressure ulcers and choking. Environmental risk assessments were in place to ensure staff were able to deliver personal care in safe surroundings.

Staffing levels were appropriate to meet people’s personal care needs. People told us they had their personal care delivered by consistent staff. They said staff mainly arrived on time and stayed for the allocated time. Staff told us there was some lone working and there was enough time allocated to deliver personal care at a pace that people preferred.

Staff that administered medicines had attended appropriate training. We saw Medicine Administration records (MAR) charts were signed to indicate medicines administered. Completed MAR charts were audited to check for any gaps in the recording.

New staff had an induction to ensure they were confident to perform their role. Staff told us the training was good. They attended twice yearly training set as mandatory by the provider. One to one observations with supervisors were monthly where “problems” could be discussed.

People were enabled to make decisions about their personal care. People said staff gained their consent before personal care was delivered. Staff knew the day to day decisions people were able to make. Where Lasting Power of Attorney was in place the type of order such as health and welfare or financial was documented in the care records.

People made their own arrangements for GP visits. Where necessary and in an emergency office staff made GP appointments. Staff said they were kept informed about visits from healthcare professionals.

People told us the staff were good and knew how to meet their personal care needs. Members of staff knew the importance of building relationships with people. For example, discussing with people their interests and getting to kno