An announced inspection of the service took place on 14 October 2016. This was followed up with visits to people in their own homes and phone calls to people to ask for their views on the service they received.

The service provided live in support to people in their own homes. This service is provided across the United Kingdom. The needs of people using the service vary widely some requiring support with personal care and others who may be living with dementia, Parkinson’s or learning difficulties.

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.

People received outstanding care which was continually reviewed to ensure the best possible outcomes. People's needs were comprehensively assessed and care plans gave clear guidance on how people were to be supported. Care was personalised so that each person's support reflected their preferences. We saw that people were at the centre of their care and found that their care and support was planned with them and not for them. People were supported to attend a range of leisure activities as well as being able to develop their own independent living skills. The service was flexible and adapted to people's changing needs and desires, enabling positive outcomes for all concerned. Each person was treated as an individual and as a result their care was tailored to meet their exact needs.

Staff were highly motivated to provide effective and compassionate care. They received comprehensive training and were provided with regular support. This included core training and shadowing which enabled them to be knowledgeable about their roles and responsibilities. Staff roles included 'champions' who had increased knowledge in areas such as dementia care. They were also provided with on-going training to update their skills and knowledge to support people with their care and support needs by a specialist training team. Further encouragement was given to enable staff to undertake additional qualifications.

People's experiences of care were extremely positive. People and their relatives were encouraged to fully engage in discussions about their care and support and this was facilitated by various communication methods. The service worked proactively to help people to make choices and decisions about their care and lifestyle and to be as independent as possible. Staff knew each person as an individual and what mattered to them. Privacy and dignity was respected by staff with whom positive relationships had been formed and who promoted individuality.

The services’ management team had a clear vision for the service and the direction of its future development. They were dedicated to providing a high quality service to the people the service supported and to the continual improvement of the service. They were influenced by the needs of the people it supported, and were committed to providing high quality care that was personalised to people's needs. Visions and values were cascaded to staff at regular meetings and during training courses, which gave them an opportunity to share ideas, and exchange information about possible areas for improvements to the registered manager. Ideas for change were always welcomed, and used to drive improvements and make positive changes for people.