This announced inspection took place at the provider’s office on 11 May 2017 with phone calls undertaken to people with experience of the service on 15 May 2017. This was our first inspection of the service.

FACT Healthcare Ltd are registered to deliver personal care. They provide domiciliary care to younger and older adults living in their own homes, who may be living with dementia, a learning disability or autistic spectrum disorder, a mental health condition, a sensory impairment and/or a physical disability. At the time of our inspection two people were receiving personal care from the provider.

The service had a registered manager. 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 were supported by care staff who knew the procedures to follow if they witnessed or suspected a person was being abused or harmed. The registered manager understood how incidents needed to be investigated fully and reported to the appropriate external bodies. Assessments were completed in relation to people’s health and welfare needs and outlined the risks for care staff to consider when supporting the individual. People received consistency in the care staff that supported them . Care staff received an induction before working more independently with people. Care staff had completed an appropriate level of training and had a good level of skills and knowledge. Care staff could access support they needed at any time from the registered manager. Care staff supported people in line with the principles of Mental Capacity Act [MCA]. People received appropriate support to ensure they ate and drank adequately. Referrals were made to relevant healthcare services as required when changes to people’s health or wellbeing were identified.

People appreciated having the same care staff because it gave them consistency as they received support from the same small number of care staff who knew their needs well. The care people received maintained their dignity and was provided respectfully. Care staff provided good quality care to people in a way that recognised them as individuals. People were involved in making decisions and were listened to by care staff. Care records outlined opportunities to optimise and promote people’s independence and described their abilities.

People received a personalised service that was responsive to their needs. Care records were individualised and staff were knowledgeable about people's support needs, interests and preferences. Provision of care was flexible to people's needs. People’s cultural and diverse needs were discussed and considered as part of their initial assessment. Each person using the service was provided with information which detailed how to make a complaint.

The provider’s systems in terms of record keeping in relation to recruitment and completion of a comprehensive induction were not robust. People were happy with the standard of care that they received. People and care staff had confidence in the abilities and skills of the registered manager. People liked the fact that the provider was a small organisation which made the service a more personal one. The provider was keen to actively involve people to express their views about the service provided. In meetings the registered manager revisited expected company standards of conduct and their expectations of care staff.