This inspection took place on 25 August 2016 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service, This was because we wanted to make sure staff would be available to answer any questions we had or provide information that we needed. We also wanted the registered manager to ask people who used the service if we could contact them.

The service is registered to provide personal care and support to people in their own homes. People who use the service may need support or care due to a learning disability or a physical disability and the service predominantly provides care and support to adults, young people, children and their families. At the time of the inspection the service was providing support and personal care to 69 people in their own homes.

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 supported by staff who had been trained to recognise the signs of abuse in children and adults. Staff were aware of their roles and responsibilities regarding maintaining people’s safety and helping them manage the risks to them on daily basis.

For those people who were supported to take their medicines, systems were in place to ensure this was done safely. Additional training was sought for staff in order to administer particular medications in an emergency situation.

Systems were in place to ensure people were supported by staff who had been recruited safely.

People were supported by staff who had received specific training to meet their particular needs. Additional training was sought to provide staff with the specialist skills they required in order to support people effectively and maintain good health.

Staff felt supported by the registered manager and the management team and benefitted from an induction and ongoing training that equipped them for their role.

Staff routinely obtained people’s consent prior to offering support and demonstrated a good working knowledge of the Mental Capacity Act 2005.

People were supported by staff who were aware of their healthcare needs and who had been trained to respond appropriately to particular healthcare issues.

People were supported by staff who were described as kind and caring and who treated them with dignity and respect. People told us that staff went ‘above and beyond’ in order to support them and meet their needs. Staff spoke warmly of the people they supported and took pride in their achievements.

People’s care needs were regularly assessed and any changes taken on board and responded to appropriately.

There was a system in place for investigating and recording complaints and people were confident that if they did raise concerns, they would be dealt with appropriately.

People were complimentary about the service they received, the care staff and the registered manager.

Staff felt supported in their role and were proud to work for the service. The registered manager had a number of links with other voluntary organisations in order to learn from and improve service delivery.

Efforts were made to regularly obtain feedback from people regarding the quality of the care and support they received. Audits were in place to assess the quality of the service and where errors were identified, they were acted on immediately and lessons were learnt.

During our visit we spoke with the manager and the care coordinator. Following our visit we spoke with six people or their representative / relative, and five staff. All the people we spoke with were complimentary about the service provided. One person told us, “I would be very sad if I had to change as X is very well looked after ’’. Another person told us, “Staff arrive when they say which is important, they are very kind and respectful. Very happy’’.

People had individual care plans that detailed what care they needed so their care needs were known and met by staff. Staff told us they had the information they needed and encouraged people to make choices about their care. One person told us, “Staff ask me even though they know what to do’’.

Staff received a range of training so that they had up to date knowledge and skills in order to support people receiving a service. All staff confirmed training was updated regularly. This meant staff should have the skills to meet people needs.

The provider had clear procedures in place to identify and respond to suspicions of abuse to ensure people were protected against abuse. All staff spoken with were clear about how they reported concerns.

There were systems in place to monitor how the service was run and listen to the views of people who used the service to ensure people received a quality service.

The majority of people using the service were unable to tell us about their experience of the service provided due to their complex needs. To help us gain further evidence of their experience we spoke with two people who use the service, four of their relatives, four staff and the registered manager. We contacted Sandwell Metropolitan Borough Council contracting department. (SMBC). They told us they had undertaken a monitoring visit to the service in February 2012 and had no concerns about the service provided to people.

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People told us they had clear information to help them make choices about whether or not they wanted to use the service. They told us that they were involved in agreeing their care and that the staff treated them with dignity and respect and observed their privacy.

We found that people received the care they needed and that procedures were in place to ensure the care was delivered safely and as agreed with the person using the service and their relatives.

We found that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Two people using the service and four relatives told us they felt safe using the service and comfortable with the staff that assisted them. One person told us “I have every confidence in the staff who look after my relative.” One person using the service told us I go shopping with staff and feel very safe in their company

We found that people received a service from staff who were trained and skilled and supported people to ensure people’s needs were met.. Staff we spoke with were confident about their roles and told us they received regular training, advice and support from the provider.