Positive Horizons Limited provides personal care and support to people who live in their own homes in Derbyshire.

We carried out this inspection on 6 December 2016. It was an announced inspection, which meant the provider knew we would be visiting. This was because we wanted to make sure the registered manager, or someone who could act on their behalf, would be available to talk with us.

At our last inspection on 13 May 2013, we found the service was meeting all standards assessed. It was compliant with the regulations and no concerns were identified.

A registered manager was 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 were appropriately recruited, trained and supported. They had undergone a comprehensive induction programme and, where necessary, had received additional training specific to the needs of the people they were supporting. Communication was effective and regular meetings were held to discuss issues and share best practice. Staff understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for.

The provider had detailed policies and procedures relating to medicines management. Staff understanding and competency regarding the management of medicines was subject to regular monitoring checks and medicines training was updated appropriately.

Staff knew the people they were supporting and provided a personalised service and used effective systems for gaining consent. Individual care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner. Risk assessments were also in place to effectively identify and manage potential risks.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

Systems were in place to effectively monitor the safety and quality of the service and to gather the views and experiences of people and their relatives. The service was flexible and responded positively to people’s changing needs and any issues or concerns raised. People and their relatives told us they were confident that any concerns they might have would be listened to, taken seriously and acted upon.

We spoke with seven relatives and one person who used the service.

People said they found the service to be reliable as people received the help they needed at their preferred times. People told us they were happy with the care and service they received. People said they received consistent care from regular staff who knew their needs. One person told us ''I cannot fault the service, the staff do a great job and are friendly and helpful.'' Another person said ''the service is brilliant and the staff are professional and caring''.

People felt listened to and able to express their views and raise any concerns with staff if they were unhappy. People’s privacy, dignity and independence was respected.

Relatives praised the care and support their family member received and said they were involved in decisions about their care and treatment.

People felt that the service has an outstanding team of staff who have the skills to meet individual’s needs.

We spoke with four people who use the service and three relatives.

People said they were happy with the care and support they received, and felt that their needs were being met. One person told us ‘’the service is better and more professional than our previous service; I couldn’t be better looked after.’’ Another person told us ‘’the service is flexible and centred around what we want.’’

People received a reliable service as they received the help they needed at their preferred times. People usually received consistent care from regular staff who knew their needs. People said they liked the staff that supported them, and described staff as caring and good at their job.

People had agreed to the care and treatment they received.

People felt listened to and able to express their views about the service.

Relatives said they were more than happy with the care their family member received, and felt involved in decisions about their care and treatment. One relative told us ‘’ the staff are professional; I can’t fault the service.’’ Another relative told us ‘’the staff are brilliant and they really care.’’

Robust recruitment procedures were in place to ensure that people were cared for by suitably qualified, skilled and experienced staff.

People felt that the service was well run. Systems were in place to monitor the quality of services provided, and to identify and manage risks to people who use the service and others.