This inspection took place between 20 and 22 December 2017 and was announced.

Integrated Crisis Response Service (ICRS) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and supports family members such as children. At the time of our inspection there were 35 people using the service. The service was managed by the registered manager who employed a team of care coordinators, assessors and support staff and they worked with healthcare professionals to meet people’s needs. People’s packages of care varied dependent upon their needs.

This was our first inspection of the service since they registered with us on 27 April 2016.

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 were involved in decisions made about their care and influenced the frequency and level of support needed. People’s needs were assessed and risks were managed and monitored to ensure they received person centred care that helped them to achieve their independence and wellbeing.

The registered manager, care manager and staff team were highly motivated and demonstrated an excellent commitment to providing care which put people at the heart of everything. ICRS staff team worked with other health care professionals and ensured a coordinated approach in the delivery of care and support which had a positive impact on people’s quality of life.

Staff worked closely with health care professionals to provide joined up care to improve people’s quality of life and independence.

Staff were recruited safely. Staff were trained in safeguarding and other relevant safety procedures to ensure people were safe and protected from avoidable harm and abuse. Staff team knew how to keep people safe and report any concerns or incident. There were enough staff to support people.

Risks to people were assessed and effective and comprehensive care plans were put in place to minimise those risks. Staff were trained and knew how best to support people to reduce risk whilst they empowered people to be more confident to be as independent and safe as possible.

People and health care professionals without exception consistently spoke positively about staff’s professionalism, skills and knowledge in how they were supported. Staff worked flexibly to ensure people’s needs were met. Staff team were valued and well supported and supervised by the management team. Staff were encouraged to influence the development of the service and people’s care. Staff followed best practice guidelines that met people’s needs and successfully supported people with their independence to stay in their own homes.

People were supported with their medicines in a safe way and their health and dietary needs were met. Staff worked with health care professionals to ensure people healthcare needs were met. People were supported to access health care services when required.

People were involved and made decisions about all aspects of their care. They 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.

People told us staff were kind and caring. Staff had developed positive relationships with people, and valued each person as individuals. Staff knew how to maintain people's privacy and dignity and promoted people to be as independent as possible.

People spoke positively about the difference made by ICRS staff team which had an enhanced sense of well-being. Staff provided continuity of care and worked in a flexible way so that they could meet people's nee