The inspection took place on 6 and 7 December 2016. We contacted the service before we visited to announce the inspection. This was because the service provides a domiciliary care service to people in their own homes. We wanted to ensure that we could access the service’s office and speak with the manager and staff.

Extra Care Home Services Ltd provided personal care to around 14 people who live in their own homes in the North Walsham area. The service provides support with other needs; however with domiciliary care services the CQC only regulates personal care.

There was a registered manager in place. A registered manager is a person who has registered with the CQC 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 were supported by staff who were safely recruited. Staff were knowledgeable in their roles and demonstrated the skills required. Staff were motivated to provide good care and understood the importance of responding to concerns about people’s health. There was a training system in place and staff training was up-to-date. Staff had a thorough induction to the service and their role.

Staff demonstrated they understood how to protect people from the risk of abuse. Staff were conscious of this issue and knew what to do if they had concerns. People and staff were protected from the potential risk of harm as the service had identified and assessed the risks people faced. People had assessments which were person centred.

People benefited from staff who felt valued by the service. Staff worked closely with the manager and found them approachable and supportive. Staff had confidence in the service they were providing. People said they saw the same care staff at regular times, and did not have missed care visits.

Staff demonstrated that they understood the importance of promoting and protecting people’s dignity, privacy and independence. They gave many examples of a caring and empathetic approach to the people they supported. People told us they were treated in a respectful and caring way. People formed positive relationships with the staff who supported them.

Staff had received training in the Mental Capacity Act 2005 (MCA) and demonstrated they understood the importance of gaining people’s consent before assisting them.

Staff assisted people, where necessary, to access healthcare services. Staff had a good understanding of people’s healthcare needs. Staff demonstrated they had the knowledge to manage emergency situations, should they arise.

The manager and staff supported people in a proactive way to avoid social isolation. People felt comfortable about contacting the manager and raising any issues they may have had. There was a complaints process in place for people to follow if they wanted to make a complaint. The manager sought the views of people, their relatives, and the staff who supported them in order to improve the service.

The manager demonstrated a real commitment to the service and to the people it supported. Staff had confidence in the manager. The manager was actively involved with every element of the service. The manager knew staff and the people receiving the service well.

During the day of this inspection, Extra Hands Home Service provided domiciliary day care to three people. We visited two people who used the service in their own homes. Both people told us that they were happy with the care and support they received and did not have any complaints. One person said, “I get well looked after”. Another person said, “I am happy. The care staff are good”.

People’s care records showed that they were fully involved in making decisions about what care and support they needed. We noted that consent was sought before any assistance was given by the care staff.

Care records were detailed, up to date and person-centred. Appropriate risk assessments had been completed and were reviewed on a monthly basis. Care staff recorded a ‘daily log’ in people’s care records. We noted that this was detailed and included all of the person’s activities of daily living needs. The care and support that had been given reflected what was documented and planned in the person’s care plan.

People who used the service told us that they felt safe and did not have any concerns. The provider had appropriate arrangements to reduce the risk of abuse to people and staff understood their responsibilities to report any suspicion or allegation of abuse.

Staff received appropriate training to carry out their roles; this included ‘in-house’ training delivered by the provider.

The service had various methods to ensure the quality of the service was monitored and audited. This included regular satisfaction surveys that were completed by people who used the service and their family members.