This inspection took place on 10 January 2018. We gave the provider two days’ notice that we would be visiting their head office as we wanted to make sure they were available on the day of our inspection.

Diligent Care Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and to people living in ‘supported living’ settings. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Diligent Care Service provides support to adults with physical disabilities, learning disabilities and people who experience mental and emotional distress. At the time of this inspection there were 60 people using the service. Of those people 17 were receiving support with personal care. The provision of personal care is regulated by the Care Quality Commission.

At our last comprehensive inspection in November 2015 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’ with some outstanding elements.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People told us they were well treated by the staff and felt safe with them.

Staff knew how to recognise and report abuse and understood their responsibilities in keeping people safe. Staff knew people were at risk of discrimination and people must be treated with respect. Staff were aware of the relevant legislation that protected people from discrimination.

Where risks to people’s safety had been identified ways to mitigate these risks had been discussed with the person and recorded so staff knew how to support the person safely.

The service was following appropriate recruitment procedures to make sure only suitable staff were employed.

Staff had completed training in the management of medicines and understood what they should and should not do when supporting people or prompting people with their medicines.

Staff were provided with the training they required in order to support people safely and effectively.

Staff offered choices to people as they were supporting them and people were involved in making decisions about their care. People confirmed they were involved as much as they wanted to be in the planning of their care and support.

Care plans included the views of people using the service. 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.

The management and support staff responded quickly and appropriately to any changes in people’s needs and care plans reflected people’s current needs and preferences.

People told us they had no complaints about the service but said they felt able to raise any concerns without worry if necessary.

The service was led by an experienced and skilled registered manager who provided a stable and consistent management style where people felt supported and included in the running of the service.

People who used the service, their relatives and the staff who supported them said they felt valued by the registered manager and by everyone who worked at the service.

Staff were proud to work for the service and said the registered manager was an excellent leader and role model.

The registered manager worked in partnership with other relevant organisations and used their feedback and feedback from quality monitoring systems to reflect on and make improvements to service provision.

This inspection took place on the 24 November 2015 and was announced. At our last inspection in December 2013 the service was meeting the regulations inspected.

Dilgent care  services provides, escorting, companionship and personal care services to adults with physical disabilities, learning disabilities and people who experience mental and emotional distress.   At the time of our inspection 16 people were receiving a personal care service.

The service had a registered manager who had been in post since the service opened in 2010. 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’s needs were assessed and care plans were developed to identify what care and support people required. People said they were involved in their care planning and were happy to express their views or raise concerns. When people’s needs changed, this was quickly identified and prompt, appropriate action was taken to ensure people’s well-being was protected. People had a copy of their care plan in their home.

People were safe. Staff understood how to recognise the signs and symptoms of potential abuse and told us they would report any concerns they may have to their manager. Assessments were undertaken to assess any risks to the people using the service and the staff supporting them. This included environmental risks and any risks due to people’s health and support needs. The risk assessments we viewed included information about action to be taken to minimise these risks.

Staff were highly motivated and proud to work for the service, as a result staff turnover was kept to a minimum ensuring that continuity of care was in place for most people who used the service.

Staff were respectful of people’s privacy and maintained their dignity. Staff told us they gave people privacy whilst they undertook aspects of personal care, asking people how they would like things done and making enquiries as to their well-being to ensure people were comfortable.

The registered manager demonstrated excellent leadership and a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. We saw that regular visits and phone calls had been made by the office staff to people using the service and their relatives in order to obtain feedback about the staff and the care provided.

The registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service. Staff were very highly motivated and proud of the service.

Support staff received regular supervision and appraisal from their manager. These processes gave staff an opportunity to discuss their performance and identify any further training they required. Support workers placed a high value on their supervision and support.

People were supported to eat and drink. Staff supported people to take their medicines when required and attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

We spoke to six people who used the service (two in supported accommodation and four in their own home), three relatives, the registered manager, three members of staff and two social workers. People we spoke to were very positive about their care, with comments made to us such as: ‘I like all my carers’, ‘they’re kind to me', ‘the care is wonderful’ and ‘they’re polite and have a great sense of humour’. Relatives told us ‘they’re really great, I don’t know what I’d do without them’ and ‘they’re well-trained and professional'.

There were enough qualified, skilled and experienced staff to meet people’s needs and those staff were supported to deliver care and treatment safely and to an appropriate standard.

People benefited from and were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines and staff were knowledgeable about them.

There was an effective complaints system available and people who used the service, relatives and staff felt confident in the provider's ability to deal with any complaint and act on feedback.

The service provided support to 14 people in their own homes. Eight of these people live in supported living and the remainder of people were cared for in the community.

We spoke with three of the people who used the service and a relative of one of the people who used the service. One person told us that the service was the “best agency I have ever had”. They also told us that they felt that they were involved with and kept informed about their care and support.

Another person we spoke with said that the support that the service had given them had been “excellent so far” and they said that they were supported to keep their home clean and to go shopping. They told us that they never had a problem as the service “provide solutions” to support them.

The people we spoke with told us that care and support was given to them by familiar faces as the service maintained continuity of care staff in delivering their care.

We spoke with of the four of the ten care staff involved in the delivery of care. They were able to demonstrate that they had a good understanding of the care needs that we had identified that people needed support with.

We found that the provider took appropriate steps to make sure that people who used the service were protected from the risks of abuse.

We found that people employed by the service to deliver care had undergone appropriate checks at the time of recruitment, to make sure they were suitable to work with the people who used the service.

We spoke with two people using the service in person and another three people on the telephone. We also spoke with two relatives of people using the service to ask their views on the quality of care provided.

People said that they were happy with the care provided by Diligent Care Services Ltd. People living in the two supported living projects said they were supported by staff. One person said, "It is really nice, I am happy there." Two people have recently moved to Holmdale Terrace from local care homes. Both said that they had settled in well, liked the staff and felt well cared for. One person said, "I am happy here and have made friends."

People using the service said they felt safe, they liked the staff, they felt their views were listened to and they were encouraged and supported to be more independent.

Relatives said they were also happy with the care provided.