About the service: Management HQ Headway provides care and support for people living in their own homes who have acquired brain injuries. At the time of the inspection there were 16 people receiving support with personal care from the provider.

People’s experience of using this service: People and their relatives were extremely happy with the care and support they received from the provider.

The management team and staff developed strong relationships with people and their relatives to ensure they received the right support to improve their quality of life.

People told us they felt safe whilst being supported by staff. Relatives were confident family members were well cared for. The provider supported people with complex needs to live independently in their own homes and to be as independent as possible whilst ensuring they remained safe and well. There was a proactive approach to assessing and managing risk which allowed people to rebuild their life following an acquired brain injury.

The provider promoted an extremely high standard of person centred care which was delivered through the assessment and planning of people's individual and specific needs. Care plans were extremely detailed and informative yet highly personal. They clearly identified the positive outcomes and goals people wished to achieve.

Staff were highly skilled, motivated and knowledgeable in the care and support required for people with an acquired brain injury. They provided flexible care and support in line with a person's needs and wishes. The staff team was consistent and people achieved positive outcomes which exceeded expectations. Staff worked alongside other family members and a range of professionals to provide people with a better quality of life, supporting them to develop in areas such as communication, social interaction and independence.

Medicines systems were organised and people were receiving their medicines when they should. The provider was following national guidance for the receipt, storage, administration, prompting and disposal of medicines.

People were involved in all decisions about the care they received. People had 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.

The provider was open and approachable which allowed people to share their views and raise concerns. People told us if they were worried about anything they would be comfortable to talk with staff or the management team.

The management structure in the service ensured people and staff had access to, and support from, a competent management team and specialist advisors. The provider monitored quality, sought people's views and planned ongoing improvements.

Rating at last inspection: Good (Report published July 2016).

Why we inspected: We inspected the service as part of our inspection schedule for ‘Good’ rated services.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We undertook an announced inspection on 26 May 2016.

We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their homes and or the family home; we needed to be sure that someone would be available at the office.

The provider registered this service with us to provide personal care and support for people with a range of varying needs including dementia, who live in their own homes. At the time of our inspection 34 people received support with personal care.

There was a registered manager for this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

Overwhelmingly, people and their relatives told us that being supported by this service made a difference to their lives. They all said the staff and management team were caring and always treated them with dignity and respect. People explained how staff regularly went the extra mile for them and how this was reflected through the management practices. Relatives told us they were involved as part of the team to support their family member.

People told us they were empowered by staff and the management team keep control over their own lives. The management team had a clear ethos that people using the service were at the heart of everything they did. This was demonstrated by people using the service being included on the board of trusties and involved in decisions about service development. People using the service were also included in their recruitment procedures. This cascaded the message to staff right from the beginning about the importance of people using the service.

People we spoke with said they had support from regular carers who knew them well. Staff we spoke with recognised the different types of abuse. There were systems in place to guide staff in reporting any concerns. Staff were knowledgeable about how to manage people’s individual risks, and were able to respond to peoples’ needs. People were supported to receive their medicines by staff that were trained and knew about the risks associated with them.

Staff had up to date knowledge and training to support people. Staff always ensured people gave their consent to the support they received. The management team regularly reviewed how people were supported to make decisions. . People were supported to eat and drink well, when identified as part of their care planning. They explained that they were supported to make their own decisions and be as independent as they could. People and their relatives told us staff would access health professionals as soon as they were needed. We saw there was effective communication with people, staff and health care professionals which improved people’s well-being.

People told us they were important to the staff and the management team. They said they were regularly asked their views about if they were happy with the support they received. People who used the service were involved with collecting feedback from other people who used the service.

People and their relatives knew how to raise complaints and the management team had arrangements in place to ensure people were listened to and appropriate action taken. Staff were involved in regular meetings, training and one to one’s to share their views and concerns about the quality of the service. People and staff said the management team were accessible and supportive to them. The management team were adaptable to changes in peoples’ needs and communicated changes to staff effectively.

The management team monitored the quality of the service in an inclusive way. The registered manager ensured there was a culture of

When we carried out our inspection of the agency it was providing personal care for adults in their own home. During this inspection we spoke with three people who used the service, the registered manager and three members of staff who visited people to provide care.

We found that before people received any care or treatment they were asked for their consent by staff who acted in accordance with their wishes. People told us: “I am listened to” and: “The things I need are done”.

People who used the service told us that the staff were friendly and provided good care. Comments included: “Very good care” and: “I like the staff”.

Staff we spoke with told us that they received training and support. One staff member told us: “The training meets the needs of the people I look after”.

The provider was able to demonstrate that they listened to people who used the service and regularly reviewed and monitored the care to make sure people received appropriate care.

We were told by the registered manager that personal care was occasionally provided to a small number of people. These people also received other services provided by Headway which were not regulated by the Care Quality Commission (CQC) and therefore did not form part of this inspection.

We spoke with one person who used the agency and one relative. We spoke with four members of staff including the registered manager. Two of these members of staff had previously carried out a limited amount of personal care with people who used the agency. The relative we spoke with described the staff as:"Sensitive" to people's care needs

People we spoke with were complimentary about the care and support that they received. We found that staff were aware of people's needs to ensure their safety and welfare. Staff were able to explain how they maintained people’s privacy and dignity whist they delivered care.

Arrangements were in place to ensure people were safeguarded from the risk of harm.

Staff had been recruited in an appropriate way and checks had been undertaken to make sure they were suitable to care for vulnerable adults.

Systems were in place to assess and monitor the quality of care provided to identify any improvements needed. This was to make sure that people were not placed at risk of receiving inappropriate care.