Passion Tree Care Services Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It is registered to provide a service to younger people, people with a learning disability, and older people. Not everyone using the service received a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

This inspection was carried out between 11 and 12 October 2018 and was an announced inspection. This is the first inspection of this service under its current registration. At the time of our inspection there were 36 people using the service.

The service had a registered manager. 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 received a safe service. Staff knew how to keep people safe and they were knowledgeable regarding safeguarding procedures.

Risks to people's safety were identified, assessed and appropriate action was taken to keep people safe. When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm.

There were always sufficient staff deployed to meet people's needs. Staff underwent relevant pre-employment checks that assured the employer they were suitable to care for people who could be vulnerable in their own homes.

Medicines were administered and managed safely by trained and competent staff. The registered manager carried out monthly audits of Medicine Administration Records (MAR).

People were supported by staff who had the necessary skills and knowledge to understand and meet people's needs. Staff felt supported and had access to training relevant to their roles.

People were supported to have sufficient amounts to eat and drink. Their care plans contained information about food and drink. People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; we saw the policies and systems in the service support this practice.

Staff had formed positive caring relationships with people who used the service and their relatives. People were supported to remain as independent as possible and staff were aware of people's individual likes and dislikes. Staff were mindful to support people in a way that maintained their dignity and upheld their right to privacy.

Staff were provided with the knowledge and equipment to reduce the risks of the spread of infection.

There were quality assurance and auditing processes in place and they contributed to service improvements. The registered manager provided clear and direct leadership to staff who had a good understanding of their roles and responsibilities. There were effective governance arrangements. There were systems in place to assess, monitor all aspects of the service.

Further information is in the detailed findings below.