The inspection took place on 3 October 2017 and was announced.

We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their homes; we needed to be sure that someone would be available at the office. A registered provider was in charge when we inspected the service. Registered providers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The service currently supports approximately 77 people living in their own home. Staff working for the service were referred to as caregivers.

People and their families spoke warmly about caregivers and felt safe with them in their homes. People and their relatives told us they were familiar with the caregivers visiting their home as they had got to know the pool of staff supporting them over a period of time.

People received care from caregivers who knew about the health conditions that they lived with. Caregivers understood people’s individual health needs and any action they needed to take to keep people safe. Some people received support with their medicines and people were happy with the support given. Regular checks were undertaken to ensure people received the correct support with their medicines.

People received care and support from caregivers who in turn felt supported through regular supervision and training. Caregivers could seek advice from the registered manager if they were unsure about aspects of people’s care. People felt confident that staff understood how to care for people and had an understanding of their individual support needs.

People’s consent was appropriately obtained by staff. Staff had received training about obtaining a person’s consent and understood what they needed to do and the importance of people understanding how they were supporting them.

People were offered choices about the meals caregivers prepared for them. People also felt assured that caregivers would seek additional help if they needed it, such help with a doctor’s appointment or to contact the emergency services.

People liked the caregivers supporting them who they saw regularly and who they felt had got to know them. Relatives also felt they had developed an understanding with caregivers about their expectations for how their family members should be care for. People’s privacy and dignity were respected by staff that understood people’s individual circumstances and levels of independence and supported people accordingly.

People felt able to discuss their individual needs and preferences with the registered manager. Preferences were respected by the registered manager and fulfilled people’s expectations of care where possible. People understood that they could complain if they needed to and the process for doing so. People also felt able to share concerns with caregivers if needed.

People’s care was regularly checked and reviewed. The registered provider had clear expectations of how the service should be delivered to meet people’s need. People found staff working for the service accessible and willing to speak with them to discuss their care needs. The registered provider was working with other stakeholders to develop how they delivered care to improve people’s experience of care.