We carried out an announced inspection of the service on 21 August 2018. Heather Healthcare Services Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It currently provides a service to older adults. All of the people using Heather Healthcare Services Ltd at the time of the inspection received regulated activity. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

Although the service had been registered with the CQC for 11 months at the time of the inspection, regulated activity had only been provided for people for three months. We considered this when assessing the service against the fundamental standards.

There was a registered manager in post at the time of our inspection. 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.

At the time of the inspection, five people received some element of support with their personal care. This is the service’s first inspection under its current registration.

People felt safe when staff supported them in their homes. Staff understood how to protect people from avoidable harm. People told us their calls were on time and they received support from the staff they expected at each call. Robust staff recruitment procedures were in place. People’s medicines were managed safely. People told us staff ensured the risk of the spread of infection was managed appropriately by staff. The provider had processes in place to investigate accidents and incidents and to learn from mistakes.

People’s care records did not always reflect current legislation and best practice guidelines. People were confident that staff understood what care they needed and supported them effectively. Staff were well trained and their professional development and performance was closely monitored. People were supported with their meals where needed. Other health and social care agencies were involved where further support was needed for people.

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 support this practice.

People liked the staff and felt comfortable when they were in their home. People felt staff treated them with dignity and respect and staff spoke compassionately about the people they cared for. People’s independence was encouraged and people were able to contribute to decisions about their care. Advocacy information was made available for people if they needed support with making decisions.

People were assessed before joining the service to ensure their needs could be met. People’s care records contained information about their personal preferences and we noted care was provided in line with people’s choices. The registered manager had ensured people’s diverse needs were discussed with them prior to care commencing. No formal complaints had been received but processes were in place to ensure they were responded to appropriately. Efforts had been made to discuss end of life care with people and staff training in this area was due to commence.

People and staff welcomed the friendly, open and caring approach of the registered manager. People and staff’s views about how to improve and develop the service were welcomed and acted on. People told us they would recommend the service to others. The registered manager understood the requirements of their role and carried out their role in line with their registration with the CQC. Auditing processes were in place.