Holmwood Gardens Domiciliary Care Services provides care and support to people living in a supported living setting, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. In addition, Holmwood Gardens Domiciliary Care Service provides care and support to people living in ‘houses of multi-occupation’. Houses of multiple occupation are properties where at least three people or more live in one household and share toilet, bathroom or kitchen facilities. CQC does not regulate premises used for supported living or multiple occupation; this inspection looked at people’s personal care and support.

Not everyone residing at Holmwood Gardens received a 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.

At the time of the inspection 15 people were receiving a service. People’s packages of care varied dependent upon their needs. Some people received continuous support over a 24-hour period, whilst others received support for a differing number of hours each day.

Holmwood Gardens Domiciliary Care 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’s safety was promoted by staff who implemented the guidance as detailed within people’s risk assessments and care plans. Assistive technology and equipment was used to promote people’s safety and independence. People were supported by staff that had been recruited and had checks undertaken to ensure they were suitable for their role. People’s medicine was managed safely and people received their medicine on time.

People’s needs were assessed to ensure the service and staff could meet their needs. The level of support people received was dependent upon their needs, which included support to access health care appointments and dietary needs, which for some included support with grocery shopping, meal preparation and cooking. Staff received support from the management team, however the frequency of formal staff supervision was not consistent. We found, people were supported to have maximum choice and control of their lives and staff supported them in the least restrict way possible; the policies and systems in the service supported this practice. This included the use of assistive technology and working consistent with the Mental Capacity Act 2005.

People using the service and a majority of family members spoke of the positive relationships they had developed with staff. People’s comments and that of their family members evidenced how these relationships had supported people, in gaining confidence to make decisions for themselves. People’s dignity and privacy was promoted and people were aware of their right to confidentiality.

People’s views, and in some instances, those of their family members had been sought to develop and continually review their care and support. Concerns and complaints had been investigated and documents supported this. People’s care plans had considered the individual needs of each person and the role of staff in meeting these. People were supported by staff to access a range of activities within the community, which included for some going on holiday with the support of staff.

People’s communication needs were considered when developing care plans, which included information as to how people communicated. This information was used to ensure people had the opportunity to make decisions and express themselves in a way that was understood by staff.

Systems were in place for people using th