The inspection took place on 13 and 14 September 2018 and was announced. This was the service’s first inspection since they registered with us in August 2017.

This service is a domiciliary care agency. It provides personal care to people living in their own homes and flats in the community. It provides a service to adults with support needs including older people, people with physical disabilities, people with mental health conditions and people with learning disabilities. At the time of our inspection they were providing care to 114 people. Not everyone using the service receives 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.

There was a registered manager in post. 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 told us they felt safe with their care workers. The provider acknowledged they needed to update care plans and risk assessments to ensure they contained sufficient information about how to mitigate risk and support people with their medicines. They started this process during the inspection.

People received care from regular care workers who were recruited in a way that ensured they were suitable to work in a care setting. The staff scheduling meant people did not always receive care at the time it had been scheduled. We have made a recommendation about staff deployment.

Staff were knowledgeable about safeguarding adults from harm and knew how to escalate any concerns they had. Incidents were investigated and action was taken to ensure incidents were not repeated.

People were involved in writing and updating their care plans. Records showed people received the care they needed. People were supported to access healthcare services and received the support they needed to maintain their health. Care workers supported people to eat and drink enough to maintain adequate nutrition and hydration.

People consented to their care, and were offered choices. Where people lacked capacity to consent to their care and treatment the service applied the principles of the Mental Capacity Act 2005.

Staff demonstrated a compassionate approach and attitude to supporting people. They spoke about upholding people’s dignity and treating them with respect. The service respected people’s cultural and religious backgrounds and the impact this had on their care preferences. The service created a safe space for people to disclose their sexual and gender identity.

People were asked to provide feedback about their experience of care through regular telephone surveys and questionnaires. People knew how to make complaints. Complaints were responded to appropriately and apologies were given when appropriate.

The provider had a policy framework in place to support people at the end of their lives. However, people were not being asked for their views in advance in line with the framework. We have made a recommendation about end of life care.

Staff spoke highly of the registered manager and we saw there was an open and friendly atmosphere in the office. The values of the organisation were clear and on display for staff to refer to. The registered manager completed a range of audits and quality assurance checks. However, the processes to ensure oversight, analysis and improvement were not yet embedded. We have made a recommendation about quality assurance systems.