This inspection site visit took place on 30 May 2018 and was announced. We gave the registered manager 24 hours' notice of our visit so they could make sure they would be available to speak with us.

This was the first inspection of the location since the provider added it to their registration in August 2017.

Complete Care Holdings Limited is a domiciliary care agency registered to provide nursing and personal care to adults and children living in their own homes across England. At the time of this inspection visit they provided nursing and personal care to 76 people and employed approximately 300 members of staff.

In 2017, at another location which the provider is no longer operating from, an incident occurred. This indicated to us that the management of risk needed to be improved. As part of this inspection we reviewed the actions taken by the provider following the incident. We found lessons had been learnt.

A requirement of the provider's registration is that they have a registered manager. There was a registered manager in post at the time of 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.

People and their relatives told us they felt safe with the staff that provided their care and support. This was because they received their care from familiar staff they knew and trusted.

There were enough staff to support people safely and the provider's recruitment procedures minimised risks to people's safety. Recruiting new staff had been one of the provider's priorities over the previous six months to ensure people received consistent care from familiar staff.

Procedures were in place to protect people from harm. Staff had received ‘safeguarding’ training to protect people from harm and described to us the signs which might indicate someone was at risk.

Detailed risk assessments identified potential risks to people's health and wellbeing. Staff had a good knowledge of the risks associated with people's care and how these were to be managed.

People felt confident that staff knew what action to take in the event of an emergency . Accidents and incidents were monitored and action was taken to reduce the risk of reoccurrence .

People received their medicines as prescribed from trained staff. Staff worked in partnership with other professionals and people confirmed they received the support and treatment they needed to maintain their health. Staff knew how to monitor and manage people's nutrition and hydration to make sure they remained healthy. Staff understood their responsibilities in relation to infection control which protected people from the risks of infection.

People and their relatives had confidence in the skills and knowledge of the staff to provide the care and support they required. New staff members were provided with effective support when they first started work at Complete Care Holdings. Staff provided positive feedback about their training. A programme of training supported staff to keep their skills and knowledge up to date. Staff received on-going support (supervision) to help guide them with their work.

The provider was working within the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible.

People and their relatives told us staff were caring and showed them kindness. People were treated with respect and meaningful relationships had developed between people, their families and staff. People’s personal care was provided in ways which upheld their privacy and dignity. People were supported to retain their independence.