This announced inspection took place on 11 and 12 January 2017. The provider was given short notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. At our last inspection in July 2013 we found the service was meeting the regulations of the Health and Social Care Act (2008) in the standards we inspected.

Neighbourhood Care HQ provides personal care and support to people living in their own homes in Burnham On Sea and the surrounding area. At the time of our inspection there were 18 people receiving a service.

When we visited 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.

Staff relationships with people were extremely caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate. Staff went over and above their caring duties in line with the philosophy and mission statement of the service. For example, one member of staff told us how they ensured people had a nice Christmas. They always liked to work Christmas day, dressed up as ‘Santa’s little helper’ and ensured people who lived alone had a home cooked Christmas dinner. Another person accidentally broke their favourite bowl. They were very upset about this. As a result, the registered manager obtained an exact replica from a website. They told us how pleased they were, stating, “I was very happy, thankful. They are very kind.”

People felt safe and staff were able to demonstrate a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. People’s views and suggestions were taken into account to improve the service. They were supported to maintain a balanced diet. Health and social care professionals were involved in people’s care to ensure they received the right care and treatment.

There were effective recruitment and selection processes in place. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received training and regular support to keep their skills up to date in order to support people appropriately.

There was good management and leadership at the service. Staff spoke positively about communication and how the registered manager worked well with them, encouraged team working and an open culture.

A number of effective methods were used to assess the quality and safety of the service people received and changes and improvements were made in response.

We used a visit to the agency and spoke with the provider and manager to gain information about the service. We saw the manager was providing care and support on a daily basis with one care worker. The provider managed the administration of the agency. We were told the agency was expanding and actively recruiting more care workers.

We also made home visits to three people who used the service and their main carers to gain their views about the service. We spoke with the care worker currently employed by the agency and observed them supporting people who used the service.

All of the people we spoke with gave positive feedback about the service and said that the manager and care worker respected their choices about the way care was delivered. A relative told us that “they understand my relative and I am very happy with the support they provide.” All of the people told us they would use the service again and recommend it to other people.

People said they felt safe using this service and knew what to do if they had any concerns. We were told they had daily contact with the manager. People told us they felt confident about contacting the manager if there were any issues.