This inspection was carried out on 21 January 2019. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office.

This service is a domiciliary care service. It provides personal care to people living in their own homes in the community. The service specialises in providing a service to adults and children with complex needs. At the time of the inspection the agency was supporting 13 people. Individual packages of care were arranged according to people’s needs and could include 24-hour care.

This was the first inspection of the service since they registered on 9 November 2017. Some people had previously received care and support from the Newcross Healthcare branch in Taunton.

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 very happy with the care they received and said they would recommend the agency. One person said, "We are very happy with our lovely carers and happy with the level of care.” Another relative said they were satisfied with everything and were impressed with the whole service.

There were systems in place to minimise risks and people felt safe with the staff who supported them. One person told us, “They are very safe. They know exactly what to do.” A relative said the service was “Very safe. They are very good with them.” Another relative felt safe to go to sleep knowing their family member was, “100% safe.”

People were cared for by small teams of staff who received specialist training to meet people’s individual needs. The provider had systems in place to ensure the service did not begin caring for people until they were sure sufficient staff with the appropriate training were available.

The provider had systems in place to ensure people received a high standard of care and support. These included nurses leading key aspects of care, supporting staff in care delivery and carrying out quality monitoring. Nurses planned people's care and monitored care practice to ensure best practice was maintained.

People or their representatives, were involved in discussions and decisions about their care and support. People told us staff were kind and caring and respected their privacy and dignity. One relative said, "They are excellent and extremely caring." Another relative told us, "They just do everything they love. Playing, reading stories. You can hear them roaring with laughter which is lovely to hear.”

Changes in people's needs were quickly identified and responded to. This meant health emergencies were responded to correctly. The service worked in partnership with other organisations to make sure people's needs were met. Increases in care needs were addressed promptly and support from other health professionals was requested when required.

People received information about how to make a complaint and all said they would be comfortable to raise their concerns with the registered manager or a member of staff. Where complaints had been made these had been fully investigated and responded to.