The inspection took place on the 19 December 2016 and was announced. We gave 48 hours’ notice before the inspection to make sure that some people who used the service, staff members and the management team were available to talk with us.

Interserve Healthcare Colchester provides domiciliary care and support for people in their own home. The service provides personal care, help, and support to people with a variety of needs. Care services are delivered to adults, children and young people with varying conditions including spinal injuries, acquired brain injuries, learning disabilities and mental health requirements. At the time of our inspection 28 adults and three children were receiving the regulated activity of personal care and / or treatment of disease, disorder or injury.

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 and their relatives told us that usually there was enough staff to meet people`s needs. However they told us that on occasions when staff did not turn up for their allocated shifts and they could not be replaced by the provider. This meant that people`s relatives had to look after people`s needs until the next shift started.

People and their relatives told us that the service was safe when delivered in their own homes and when people were supported accessing the community. Staff had received training in how to safeguard people from abuse and were knowledgeable about the potential risks and how to report concerns.

People were placed at the heart of the service. Experienced staff met and assessed people`s needs before they started using the service. Staff were recruited specifically considering people`s needs and also their personalities to match with the people they supported. Staff were recruited through robust recruitment procedures.

There were good systems and processes in place to keep people safe. There were clear risk assessments for each identified risk to people`s health and well-being and clear guidance for staff about what actions to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe.

People`s medicines were safely administered by trained staff who had their competencies regularly checked. People were supported to maintain good health and had assistance to access health care services when needed.

People’s capacity to make decisions was regularly assessed and staff were following the Mental Capacity Act 2005 (MCA) principles. Best interest decisions were in place for people who lacked capacity to take certain decisions and these were taken following a best interest process.

Staff felt supported by their manager. They were given training updates, supervision and development opportunities. Staff undertook training and development courses to increase their understanding of the needs of people using the service. Each person supported by the service had a small team of staff looking after their needs. The team had bespoke training and support to understand each person`s health condition and needs before they cared for the person.

People and relatives told us that staff were kind and caring. People and relatives confirmed that staff respected their privacy and dignity. Staff had a firm understanding of respecting people within their own home and providing them with choice and control. People were supported at mealtimes to access food and drink of their choice.

The registered manager monitored the quality of the service by the use of regular checks and internal quality audits to drive improvements. Feedback was sought by the registered manager through surveys which were sent to peop