This inspection took place on 5 July 2017 and was unannounced.

C.L.C.A Company Limited is registered to provide nursing and personal care to children and adults in their own homes. There were two people using the service at the time of our inspection. The service specialises in providing nursing care to children and adults with a range of complex care needs. Staff are able to support people who have needs such as home ventilation, tracheostomy, gastrostomy or suprapubic catheters.

A registered manager was in post and was present during our inspection. 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.

Staff had received training in and understood how to protect people from any harm and abuse. Systems were in place for staff to follow which protected people and kept them safe. Staff knew how to and were confident in reporting any concerns they may have about a person’s safety.

Risk assessments reflected how care should be provided to the person to minimise any risks to them. They were regularly reviewed to adapt the level of support needed in response to people's often rapidly changing needs.

The provider organised their staffing requirements based upon people's care needs and staff teams were built around individual people. They followed safe recruitment practices that ensured that those staff who were providing care were suitable to be working with people in their own homes.

People were supported by staff who had been trained to support them with their specific care needs. People and relatives contributed to the training of staff to ensure they were competent in their roles.

Staff asked people’s permission before they helped them with any care or support. People’s right to make their own decisions about their own care and treatment were supported by staff.

Staff adopted a caring approach towards their work and had built good relationships with the people they supported. People and relatives were happy with the care provided, trusted staff and felt staff were kind and compassionate.

People received care and support that was individual and personalised to them and their preferences. Staff worked closely with healthcare professionals in order that the assessment, monitoring and delivery of care met their complex care needs.

The provider sought the views and experiences of people, relatives and staff to maintain a culture of continuous improvement within the service. A system was in place to investigate and respond to complaints and concerns.

Staff worked for the benefit of the people who used the service. The provider had instilled a culture of continuous improvement and of putting people first, above anything else. The provider and registered manager encouraged an open, on-going dialogue with people, their relatives and the staff team. Quality assurance checks were carried out to help ensure people received a good quality of care.