This inspection started with a visit to the office location on 22 June 2017 and was announced. We gave the provider 48 hours’ notice of the inspection to ensure that the people we needed to speak with were available. On 24 June we made calls to people who use the service and staff to gain their views and experiences. This was Noble Live-In Care’s first inspection since they registered with CQC in May 2016.

The inspection was carried out by one adult social care inspector. At the time of this inspection the service was providing the regulated activity of personal care to 15 people who lived in their own homes. The agency was providing care to people in different locations throughout England. These services were managed by the agency from an office in South Gloucestershire. People using the service, their families and Noble Live-In staff used the term ‘care companion’ when referring to care staff. Therefore, we will refer to staff as companions in the report and staff when we refer to them collectively. The management team consisted of the provider, registered manager, a training coordinator/care manager and a recruitment/administration manager.

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.

The feedback we received from people was very positive throughout. Those people who used the service expressed great satisfaction and spoke highly of all staff and services provided. One person told us, “The whole experience has been first class, I couldn’t have wished for more”.

The safety of people who used the service was taken seriously and the registered manager and staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.

The whole staff team were highly motivated and proud of the service. All staff were fully supported by the management team and a programme of training and supervision enabled them to provide a good quality service to people. The registered manager, provider and all staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected.

The registered manager ensured that staff had a full understanding of people’s care needs and had the skills and knowledge to meet them. People received consistent support from care companions who knew them well. People had positive, caring relationships with their companions and were confident in the service. There was a strong emphasis on key principles of care such as compassion, respect and dignity and promoting independence. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.

People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care package amended to meet their changing needs. The service was flexible and responded very positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.

People benefitted from a service that was well led. The vision, values and culture of the service were clearly communicated to and understood by staff. The provider had implemented a programme of ‘planned growth’ that had been well managed. The provider and registered manager were very committed to continuous improvement. The registered manager demonstrated strong values and, a desire to learn about and implement best practice throughout the service.

The registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There wer