Nurse Plus and Carer Plus (UK) Limited provide personal care and support to people living in their own homes. At the time of our inspection 20 people were using the service which came under the regulated activity. The inspection took place on the 13 December 2016 and was announced.

A registered manager was employed by the service. 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 registered manager was available throughout the inspection.

People told us they felt safe with the care and support they received from the service. Staff had received training in the safeguarding of vulnerable adults and were aware of their responsibility to report any concerns. Policies and procedures were in place to guide staff on what they should do if they had concerns. Risks were assessed and reviewed regularly and control measures were put in place to minimise the risks to people. There were effective pre-employment checks for the safe recruitment of staff, including criminal records checks and obtaining character references.

People and their relatives were all positive about the caring qualities of staff. They told us they felt comfortable with the staff members and were able to approach them with any concerns they had. Each person was allocated a small team of staff so they always knew who would be supporting them. This enabled continuity of care and relationships to be established. People told us staff were respectful of their privacy and dignity when providing personal care.

People were involved in discussions about the care and support they wished to receive. Care plans were personalised and contained information on their specific needs and preferences, and how they wanted these to be met by staff. People told us they were treated as individuals and felt they were supported in the way they wanted. Staff were knowledgeable about the people they supported. Staff provided people with the care and support they required in line with their care plans.

People were supported to stay healthy and well. Staff explained how they monitored people’s well-being during their visits. If they had any concerns about a person’s health they would record this and report their concerns to ensure appropriate action was taken. People received their medicines as prescribed and safe management processes were in place and followed by staff.

Staff received the appropriate training to meet people’s needs. The head of training monitored training to ensure staff skills and knowledge were kept up to date. Staff received regular supervision (one to one meetings) and appraisal so that they were appropriately supported to care for people. Staff felt management were approachable and supportive.

There were sufficient staff to meet people’s care and support needs. People were supported by people that were of good character and were suitable for the role. People did not have major concerns about staff turning up late or missing a scheduled visit. Staffing levels were monitored by the homecare coordinators and registered manager to ensure people received continuity of care.

People and their relatives knew how to make a complaint if needed. The registered manager routinely sought the views and experiences of people using the service about the quality of care and support they received and if it could be improved upon. There were quality assurance systems in place to monitor the quality of service being delivered and to make improvements where needed.

The service was working within the principles of the Mental Capacity Act 2005. People told us staff sought permission before undertaking any care or support. Staff had an understanding of the Mental Capacity Act 2005 and explained how t