This inspection took place on 28 June and 8 July 2016 and was announced. We gave the provider 48 hours’ notice because the service is a small home care agency and the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in.

Mill Farm provides personal care to people with physical disabilities, dementia, mental health problems and learning disabilities who live in their own homes in order for them to maintain their independence. At the time of our inspection the provider confirmed they were providing personal care to 50 people. Mill Farm is part of the Home Instead franchise which is a nationwide organisation.

This service was last inspected 3 September 2013 and was compliant with all regulation.

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 were cared for and supported by staff who received excellent and innovative training and support to ensure that they understood their needs and how to meet them in the most personalised way. Staff were also supported through supervision and appraisal and they valued the support they received, including support to study for further qualifications. Staff were encouraged and rewarded for going the 'extra mile'.

The service regularly sought out new ideas and contacts to enable the development of the staff team and the improved care of the people being supported. People and their relatives told us that they received care and support that had a significant positive impact on their lives. People had risk assessments in place to enable them to be as independent as possible

People using the service and their relatives told us overwhelmingly that staff were excellent and supported them in a caring and compassionate manner. Positive comments were also received about the support provided by the registered manager. People were 'matched' with staff so that they were supported by staff who understood them and were able to care for them in a consistent manner. Staff were knowledgeable about people’s needs and preferences and had developed caring relationships with them. The service also supported staff where they had experienced a death of a person who used the service. People’s privacy and dignity was maintained at all times. Caring and compassion was promoted amongst care staff by the provider and registered manager.

There was collaboration with other services such as The Women's institute and Fire Service to raise awareness of dementia and where people could be vulnerable to 'scams'. This meant that positive outcomes were achieved for people including feeling empowered and being part of a wider community.

Recruitment processes were robust and ensured only suitable people were recruited to work with people who used the service. The recruitment procedure emphasised the importance of kindness and compassion. People were not recruited unless they demonstrated those characteristics. As the registered manager only took on packages of care when they had the staff to fulfil the requirements there were sufficient numbers of staff available to meet people’s care and support needs. This meant that home care visits were consistently made at times that people expected. People contributed to the assessment of their needs and on going reviews of their care. This was so that care and support was provided in the way people preferred and this was reflected within their individual care plans. People told us that when they expressed preferences about their care and support these were acted upon by the service.

People knew how to raise concerns if they felt they had to and they were confident they would be taken seriously

We spoke with relatives of two of the 20 people who used the service. One relative told us, "The service is very good. They are very caring. They match carers with people they support." The other relative told us, "The carers always come on time. We have the same carers which is important to us. The carers show that they understand dementia. The service have responded to the changing needs of my wife." We saw feedback that most of the people who used the service provided shortly before our inspection. We found that people were very satisfied with the quality of care and support they had experienced.

It was clear from what people told us and what we saw in care plans and other documentation that people and their relatives had been involved in decisions about care and support. People had been involved in the assessments of their needs and in reviews of care plans. We found evidence that the service had responded to peoples changing needs.

Relatives told us that they felt that care workers had been well trained to understand the needs of people they supported. Our review of training records and training material found that care workers had received appropriate training. Care workers told us that the training they had received had equipped them to carry out their role with confidence. We found that care workers had carried out the required care routines with dignity and respect for people they supported.

The service was very well led.

We spoke with one person who used the service and two relatives of two other people who used the service. The person who used the service told us, "I'm very satisfied. The people who visit me are very kind and considerate." That person added, "What pleases me is that the people who visit are local people." Relatives also had positive views about the care workers. One relative told us, "The carers are excellent. What is very good is that the service provides carers who understand people's interests. The service matches carers and people they visit." Another relative told us, "The carers are good, they are well trained." That relative added, "I've been involved in decisions about the care package. The service has been very cooperative."

What people told us about the service was corroborated by what we found when we reviewed care plans and other documentation and spoke with staff. The service had involved people in their care plans and that included ensuring that people were satisfied with the care workers who visited them. The service placed people's needs and preferences at the centre of how it operated.