We carried out an announced inspection of the service on 13 December 2017.

A registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Jigsaw Homecare Limited currently supports 46 people who receive some element of support with their personal care. This is the service’s second inspection under its current registration. At the last inspection on 23 June 2016 the service was rated Good overall. After this inspection the service maintained this rating.

People continued to receive safe care and processes were in place to reduce the risk of people experiencing avoidable harm. Safe staff recruitment processes were in place, although more robust checks of staff criminal records were needed. There were enough staff to meet people’s needs. Safe medicine management processes were in place and people received their prescribed medicines safely. Staff were aware of how to reduce the risk of the spread of infection and processes were in place to investigate accidents and incidents appropriately.

Staff were well trained and their performance was regularly monitored. People were treated equally and were not discriminated against as a result of their health needs. Where needed, people were supported to lead a balanced and healthy lifestyle. The registered manager had ensured effective relationships with external health and social care organisations were in place and people’s health was regularly monitored. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; there were policies and systems in the service support this practice. However clearer documentation was required to ensure all decisions made clearly evidenced that they were in each person’s best interest.

People felt staff were caring, treated them with respect and dignity and listened to what they had to say. Staff talked with people and made them feel valued. People were supported by staff who were respectful and empathetic. People were involved with making decisions about their care. People’s diverse needs were respected. People were encouraged to lead as independent a life as possible. People were provided with information about how they could access independent advocates.

People were supported to lead their lives in the way they wanted to. For some, this meant support to access their community and carry out their preferred hobbies and interests. People and their relatives were involved with agreeing the level of care and support people would receive when they started to use the service. Care records contained person centred guidance that enabled staff to respond to people’s individual preferences. People were treated equally, without discrimination and systems were in place to support people who had communication needs. People felt able to make a complaint and were confident it would be dealt with appropriately. The provider’s complaints process needed updating with the local ombudsman’s details.

People and staff felt valued and spoke positively about the registered manager. The majority of people spoken with would recommend this service. Staff were made aware of the provider’s aims and values and were held accountable for their actions. The service was managed well by a registered manager who was dedicated to improving people’s lives. The registered manager and the provider continually looked to improve the service provided and expanded their knowledge by attending locally run forums. Quality assurance processes were in place and these were effective.

This inspection took place on 13th April 2016 and was announced.

Jigsaw Horizons Limited a domiciliary care service which provides personal care and support to people to enable them to live independently in their own home. At the time of inspection 37 people were receiving personal care from the service.

The service has 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 who used the service and those supporting them knew who to report any concerns to if they felt they or others had been the victim of abuse. Any risks to the health and safety of people and staff had been identified and detailed plans were in place to reduce these risks. Accidents and incidents were investigated. There were enough staff to attend all planned calls punctually and meet people’s needs. People received their medicines as prescribed, and staff provided people with as much or as little support they needed to ensure this.

People were supported by staff who had received the appropriate training to support them effectively. Staff received supervision of their work. People received the support they required from their staff to ensure they had sufficient to eat and drink. People were provided with the support they needed to enable them to have access to their GP and other health care professionals when they need them.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff were aware of the principles of the MCA and how this might affect the care they provided to people. Where people had the capacity they were asked to provide their consent to the care being provided.

People were supported by staff who were caring and treated them with kindness, respect and dignity. People were involved in the planning and reviewing of their care to ensure that they received the care they wanted.

Care plans were written in a way that focused on people’s choices and preferences. A complaints procedure was in place and people felt comfortable to speak up if they were unhappy about any aspect of the service they received.

The culture of the service was open. People were supported by staff who were clear about what was expected of them and staff had confidence that they would get the support they needed from the registered manager. People and staff were asked for their opinions about the quality of the service. The registered manager undertook audits and observed practice to ensure that the care provided met people’s needs. There were strong links with other community resources to ensure that people got the best support possible.