The inspection took place on 15 and 18 December 2017 and was announced. The provider was given 48 hours’ notice because the location provides personal care to people in their own homes and we needed to be sure someone was in.

This service 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.

HAIL- Domiciliary Care Service provides support to adults who have a learning disability. At the time of this inspection there were eight people using the service.

The service was last inspected in November 2015 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

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, felt safe with them and trusted them.

Staff knew how to recognise and report abuse and they understood their responsibilities in keeping people safe. Staff understood that people were at risk of discrimination and knew people must be treated with respect. Staff understood there were laws to protect 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 that only suitable staff were employed.

Staff had completed training in the management of medicines however no one using the service currently needed any support with their medicines.

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

Staff offered choices to people as they were supporting them and people told us they felt 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 staff were quick to respond 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.

The service had a number of quality monitoring systems and people confirmed they were asked about the quality of the service and had made comments about this.

Staff were positive about the management and understood the vision and values that underpinned the service.

At the time of the inspection twelve people were using the domiciliary care service. We met or spoke with six of them, and one family member of a person receiving a service.

People were very positive about the service, indicating that they were provided with the care that they need, and were given choices about the support they received. One person told us “they help me,” and another advised “I go out a lot.” A family member told us “they ask him questions about how he wants things done,” and “they are always on time.”

People had formed good and supportive relationships with staff and management. People were supported to access healthcare professionals when needed, and were also supported to undertake varied activities in their own homes and in the community. We noted significant improvement with regard to staff supervision and training and recruitment procedures for volunteers providing domiciliary care. The majority of people received their medicines appropriately. However there was room for improvement in the recording and monitoring of medication administered to people, to ensure that they are protected from the risks associated with the unsafe use and management of medicines.

This inspection took place on 11 and 18 November 2015. We told the service about this two days before the inspection to ensure that management were available.

HAIL - Domiciliary Care Service is registered to provide personal care services to adults, particularly those with mild to moderate learning disabilities, within the Haringey area. At the time of our inspection 12 people were using the service, living in their own homes or at supported living projects run by the provider organisation. There were sixteen support workers working for the service. At our last inspection in December 2013 the service was meeting the regulations inspected.

The service had a registered manager in place. 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.

We found that people received safe care and had formed good relationships with staff members supporting them. They described staff as caring and flexible in providing them with the support they needed.

Staff received appropriate training, supervision and support for their roles. Most staff had received training in the Mental Capacity Act 2005, and others were scheduled to do so. They understood the importance of obtaining people’s consent prior to providing care.

Staff were knowledgeable about the needs of the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported, and risk assessments were in place to minimise the risk of harm. People spoke highly of the support staff provided including support to meet their cultural needs and to support them in activities of their choice.

People were supported to eat and drink according to their preferences, and to attend health care appointments when needed. Safe systems were in place for staff to support people to take their prescribed medicines.

People told us that the registered manager and deputy manager were accessible and approachable, and that they felt able to speak up about any areas for improvement. There were regular checks in place to review the quality of the service provided to people.