This was an announced inspection carried out on 12, 19 and 20 February 2019. We gave 24 hours' notice of the inspection to ensure someone would be available at the office.

This was the first rated inspection of Clements Health Care since it moved location and was re-registered in 2017.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. 20 people were using the service at the time of our inspection.

A registered manager was in place. 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 and relatives told us the service kept them safe. They trusted the workers who supported them. Risks to people were assessed and plans put in place to mitigate any assessed risk. Policies and procedures were in place to safeguard people from abuse. People's medicines were managed safely. The provider's recruitment process minimised the risk of unsuitable staff being employed.

There were sufficient staff employed and people received a reliable and consistent service. Staff were well-supported due to regular supervision, annual appraisals. A robust induction programme, which developed their understanding of people and their routines, was in place. Staff also received training to ensure they could support people safely and carry out their roles effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice. Staff had received training and had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, when people were unable to make decisions themselves.

Staff knew the people they were supporting well. Care plans were in place that provide some guidance about how people wished to be supported. People were involved in making decisions about their care. Staff had developed good relationships with people. They were caring in their approach and treated people with respect. Care was provided with patience and kindness. Staff upheld people's human rights and treated everyone with great respect and dignity.

Staff were aware of people's nutritional needs and made sure they were supported with eating and drinking where necessary. People's health needs were identified and staff worked with other health care professionals to ensure these were addressed.

People, their relatives and staff said the management team were supportive and approachable. Communication was effective, ensuring people, their relatives and other relevant agencies were kept up-to-date about any changes in people's care and support needs and the running of the service.

A complaints procedure was in place if people or their relatives needed to raise a complaint.

People, relatives and staff spoke well of the registered manager and they said the service had good leadership. There were effective systems to assess and monitor the quality of the service. These methods included feedback from people receiving care. Staff performance was subject to periodic spot checks.