We undertook an announced inspection on 8 February 2018. At our previous inspection on 3 December 2015 we rated the service ‘good’ overall and in all five key questions. At this inspection we found the service continued to be ‘good’.

Headstart is a service which is registered to provide personal care to adults in their own homes. At the time of our inspection there were five people using this service.

The registered manager remained 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 2008 and associated Regulations about how the service is run.

The service was safe. Risk assessments were completed to enable people to receive care with a minimum of risk to themselves or the staff. Robust recruitment procedures were followed to ensure as far as possible only suitable staff were employed. Staff were trained to safeguard and protect people. They were aware of their responsibility to report concerns.

The service was effective. People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required.

The service was caring. People were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People's views were actively sought and they were involved in making decisions about their care and support.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. The registered manager responded to complaints received in a timely manner.

The service was well led. There was a positive culture within the staff team and staff spoke positively about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The director, registered manager and staff were committed to providing a good service for people. There were quality assurance systems in place to help ensure any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People told us they were regularly asked for their views about the quality of the service they received.

This was an announced inspection that took place on 3 December 2015. At our previous visit on 10 April 2013, we judged that the service was meeting all the regulations that we looked at. Headstart is a domiciliary care agency providing personal care and support for four adults living in their own homes.

The service had a registered manager in post at the time of this inspection who told us they were due to retire from this role. A new manager was recently appointed and has applied to the Care Quality Commission to become the new 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 told us they felt safe with the service they received. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service and staff about how to report suspected abuse. This meant appropriate action was taken to deal with suspected abuse and help provided to protect people who use services

People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe.

The registered manager ensured there were safe recruitment procedures to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

Staff received training in areas of their work identified as essential by the provider. We saw documented evidence of this.

People told us they were prompted by staff with taking their medicines and this was confirmed by staff. Staff had received training so they were able to safely administer medicines if necessary.

People said they were treated with kindness and compassion in the care they were provided with by staff and they said that their care was good.

Staff told us they received training on how to promote and maintain people’s dignity and privacy. This had helped people to feel they mattered and were understood.

Staff respected people’s privacy and dignity. People said staff asked them how they would like things to be done and were polite.

Staff told us that wherever possible people were encouraged to maintain their independence and undertake their own personal care. Where appropriate staff prompted people to undertake certain tasks rather than doing it for them.

People told us they were involved in the care planning process and they said the service responded to their needs and individual preferences. People also said that staff supported people according to their personalised care plans, including supporting them to access community-based activities.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner. People were aware of the agencies’ complaints policy.

People gave positive feedback about the management of the service. The director and the manager were clear in their views about the importance for service improvement based on feedback provided by people. They told us their aim for the service was to progress towards providing a better standard of care. We found there was a positive management ethos that included an open and positive culture with approachable staff and a clear sense of direction for the service.