This service is a domiciliary care agency. It provides personal care to people living in their own house. It provides a service to children, young people and adults with Autism and associated conditions and other disabilities.

We carried out this inspection on 19 December 2017. It was an announced inspection, which meant the provider knew we would be visiting. This was because we wanted to make sure that the registered manager, or someone who could act on their behalf, would be available to talk with us.

At our last inspection on 19 July 2016, we found that the service was meeting all standards assessed. It was compliant with the regulations and no concerns were identified.

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.

There was a strong ethos of delivering high quality, person centred care and this was a culture which was embedded with the staff team. There were strong support systems in place for staff which enabled them to feel valued and motivated to provide innovative, high quality support to people.

People and their relatives spoke very positively about the management of the service and felt that the registered manager was professional, readily accessible, approachable and always very helpful.

Oversight of the service and staff, both formal and informal, enabled the management team to regularly monitor the service provided and ensure all care and support was consistent, responsive and reflected people's ongoing and changing needs.

People, relatives and professionals told us that staff were kind, caring and compassionate.

Staff were appropriately recruited, trained and supported. They had undergone a comprehensive induction programme and, where necessary, had received additional training specific to the needs of the people they were supporting. Communication was effective and regular meetings were held to discuss issues and share best practice. Staff understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for and supported.

The provider had detailed policies and procedures relating to medicines management. Staff understanding and competency regarding the management of medicines was subject to regular monitoring checks and medicines training was updated appropriately. Staff understood what support people needed to manage their medicines safely and these were given as prescribed. There were processes in place to audit the accuracy of recording medicines.

Staff knew the people they were supporting and provided a personalised service and used effective systems for gaining consent. Individual care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner. Risk assessments were also in place to effectively identify and manage potential risks.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests. Staff we spoke with were able to explain how they considered capacity and consent when they supported people.

People received support, where appropriate, to eat and drink sufficiently. People were also supported to access a range of healthcare professionals, as and when required.

Staff respected people's privacy and dignity. They encouraged, enabled and supported people to be as independent as possible and there was a strong focus on working with people, as opposed to working for them. People’s individual communication needs were assessed and they were supported to