We inspected this service on 24, 25 September and 2 October 2018. This was an announced inspection and we telephoned two weeks before our inspection in order to arrange telephone interviews with people. The service offers a service to people who receive a personal health care budget and Home Care Direct manages their care on their behalf. People who use the service choose their own team of staff or employ family members as carers. People referred to these members of care staff as ‘personal assistants’ and this term has been used within this report. There were 53 people using the service at the time of our inspection. This is the first comprehensive inspection for this provider under their current registration.

The 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 felt safe and personal assistants were trained in safeguarding adults and understood how to protect people from abuse. Where risks had been identified, measures were taken to reduce or prevent potential risks to people. People had support to take their medicines at the right time and personal assistants knew how to act if medicines were missed. Recruitment checks were carried out prior to assistants starting work to ensure their suitability to work with people who used the service. The registered manager and team of staff reflected on how the service was managed to ensure lessons could be learnt and any improvements made.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were actively involved in making choices and decisions about how they wanted to live their lives. Personal assistants sought people’s consent before they provided care and support and people were involved in the planning and reviewing of their care. People were treated with dignity and respect by personal assistants who understood the importance of this. Where assistance was required, people received support to prepare and eat their meals and had access to food and drink between support visits.

People had been involved with developing their care plans and felt these reflected their support. They were positive about the relationships they had formed with their personal assistants and the care they received. Personal assistants were respectful and protected and maintained their privacy and dignity when offering care and support. Staff members understood the need to ensure all information was respected and maintained confidentially. People's care records were kept securely in the provider's office to help ensure that they could only be accessed by people authorised to do so.

The personal assistants were kind and caring and had the right skills and experience to provide the care and support people required. People benefitted from receiving a service from personal assistants who were happy in their work and supported. There were enough suitably trained personal assistants to deliver safe and effective care to people and they received supervision to ensure they remained competent in their role.

People’s care was reviewed with them and family members to ensure it continued to reflect their personal care needs. People knew how to make a complaint if they needed to. People were confident they could raise any concerns or issues with staff in the office and the registered manager, knowing they would be listened to and acted on.

Quality assurance systems had been developed to monitor how the service was delivered and people were able to comment on the quality of the service. The provider worked with other health and social care professionals to ensure people received an individual service that