The inspection took place on 9 February 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. People lived within their own individual flats and shared some communal areas.

The provider registered this service with us to provide personal care and support for people with a range of varying needs including dementia, who live in their own homes.

The service provides personal care to people living either in their own home or the home of a family member. At the time of the inspection, approximately 30 people used the service and 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 and associated Regulations about how the service is run.

People were familiar with staff who regularly attended to their needs and who they felt safe and comfortable around. Staff had received training and supporting on protecting people from harm. Staff understood people’s health and the action they needed to protect their health and wellbeing. Staffing numbers were monitored to ensure there were sufficient number of staff available and contingency was in place to cover any unplanned staff leave. Staff underwent recruitment and background checks to assure the registered provider of their suitability to work at the service. Staff competency to support people with their medicines was monitored regularly.

Staff had access to supervision and support and understood how to obtain a person’s consent. The registered manager had a process in place for when people were no longer able to make decisions for themselves. People were offered choice in the meals and drinks prepared for them. Staff understood how to escalate concerns about a person’s health and people felt assured they would get the help they needed.

People liked the staff and regarded them as their friends. People had access to regular staff who they felt understood their needs and checked they were happy with their care. People felt respected by staff who supported them to maintain their dignity and independence.

People were involved in regular reviews to ensure their care met their needs and preferences. People’s care was amended to reflect changing circumstances. People understood they could complain if they needed to and felt confident their concerns would be listened to.

People knew the management team and felt able to access them and discuss matters of importance to them. People’s care was reviewed and monitored regularly to ensure it met the registered provider’s expectations of care. The registered provider was exploring further ways of reviewing the quality of care people received and was hoping to expand the service further.