This inspection took place on the 30 December 2016 and 3 January 2017. The service was last inspected on 6 February 2014 and we found it was meeting all the legal requirements at that time.

We gave the provider 48 hours’ notice of our visit. This was because the service was a domiciliary care agency and we needed to be sure that people and staff would be available to speak with us.

Care Choice is a domiciliary care agency based in Trowbridge that mainly specialises in providing care and support to adults and children with a learning disability, who live in Wiltshire. At the time of the inspection the service were providing support to around twenty five people.

There was a registered manager for the service. 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.

There were systems in place to minimise risks to people from harm. The provider had appropriate policies and procedures to guide staff to on how to safeguard people from abuse. Staff were knowledgeable about how they should respond to a safeguarding concern. Risks to people were minimised because staff knew how to identify and report any safeguarding concerns. Employment checks were carried out on all staff before they supported people, to ensure that they were suitable to work with people.

People were matched with staff to ensure they were happy with them. Visits were planned to ensure that there was always enough staff time, and that the staff were sufficiently qualified and competent. All of the team knew people well and this really helped to ensure care was consistent.

Staff were very kind, caring and supportive .They treated people with the upmost dignity and very respectfully. Many of the people the staff supported ,due to the nature of their disability, found it difficult to communicate with others and build relationships. The staff had developed positive and trusting relationships with them and they supported people's family members. The service had gone the 'extra mile' to support people with their particular needs.

People and their families were very happy with the standard of care and support they received. Family members told us they felt that the level of support provided was exceptional. They said that staff went above and beyond their role to support people.

People were supported in a way that was extremely flexible and continuously adaptive to their needs. The service was always looking to find new creative ways to meet people's individual needs. This included responding to emergency situations in people's lives in a caring way. This meant people could continue to receive the support they needed.

The service went the extra mile to provide additional support for people who may be isolated. A community creative arts and crafts group had been formed that people did not have to be funded to use. People benefited from this initiative.

The views of people, their relatives and the staff team views were regularly sought. When a shortfall in the service was found actions for improvement were put in place. Information was available about how to follow the complaints process and relatives said their concerns had been addressed in a very open way and this meant there was no need for them to make a formal complaint.

The director and registered manager were very open, approachable and supportive. The atmosphere in the organisation was relaxed and informal. The staff team who they led understood the aims of the service and were extremely motivated to supporting people according to their choices and wishes.

There were effective quality-checking systems in place to review the quality of the service. The service actively sought specialist advice and guidance to further improve

We found that staff consulted with people who used the service or their advocates in order to gain their consent. People's health and welfare needs were being met and they were happy with the support provided. We found the management of medicines to be safe and appropriate to people's needs. Staff were competent and well supported by the management team. The quality of the service was being monitored and systems were in place to manage risks to people's health, welfare and safety.

We visited the offices of the Care Choice, Magnaset Ltd, where we met with one of the directors and some of the office staff. We spoke with six people who used the service and four members of staff during our inspection process.

People experienced care and support that was planned around their individual needs. People told us they were involved in making decisions about how they were going to be supported and have their care needs met.

People told us the service listened to them and they knew who to speak to if they had any concerns. People told us they liked the staff that came to their home and described having a good relationship with them.

Staff received training and guidance which helped to ensure they supported people safely. When people told us about the staff team their comments included "they are helpful” and “I think they are great.” Staff said they felt supported by the manager and were informed about any changes to the service.

The records held by the service in their offices and people’s own home were complete and kept up to date. This helped and supported staff to maintain the comfort and well being of people using the service.

Systems were in place for monitoring the service and collecting people's views on the quality of the care they received.

Having assessed the available evidence, we considered the service demonstrated how it met the safety and welfare needs of the people using the service.

People and their supporters told us that they were happy with the care provided by Care Choice. They told us that they were involved in the day to day decision making.

People said that their privacy and dignity was respected. People spoke positively about the staff. They said that they were competent, well trained and that they felt safe. One person summed up the various comments received by saying “we are very happy with the service.”