Sarah’s Home Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older people, some of whom are living with dementia, people with physical or learning disability, and people with a mental health need. 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.

Sarah’s Home Care Limited provides the regulated activity of personal care from an office based in Watford. At the time of this inspection there were 14 people using the service.

This inspection took place over three days. On the 12 April 2018 we visited the site office. On the 19 April 2018 we visited people in their own homes and on 23 April 2018 we contacted relatives in order to obtain their feedback about the service. We gave the provider 48 hours’ notice of our intended inspection to make sure that appropriate staff were available to assist us with the inspection.

The service had 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.

This was the first comprehensive inspection since the service was registered with the CQC in January 2017.

At this inspection we found that people received care and support in a safe, effective and personalised way.

Staff knew what keeping people safe meant as well as how to achieve this by managing any identified risk. Staff were trained in safeguarding people and were informed about who they could report any incident of harm to.

People were given information in a format that they could understand about staying safe.

Robust checks were in place to check that staff were only employed once they had been safe and suitable to care for people using the service.

People's needs were met by staff who were trained appropriately for their role and they were deployed to ensure people’s needs were met.

People were supported to take their prescribed medicines safely. Staff were trained and deemed competent to support people's medicines by staff who had the skills to do this.

Staff were supported in their role and they knew what standard of care was expected. Incidents were used as an opportunity for learning and to help drive improvements.

People were enabled to access healthcare services. People's nutritional needs were met by staff who knew each person's needs well. Staff knew when people needed support and also when to respect people's independence.

The equipment that staff supported people with was regularly checked to make sure that it was safe.

A positive and good working relationship existed between the registered manager, care staff and relevant stakeholders. People were supported in partnership with other organisations including healthcare professionals to help provide joined up care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were involved in their care and relatives or friends helped provide information, which contributed to people's independent living skills.

People's care plans contained detailed information about the person to assist staff with providing person centred care. Staff understood how to provide care that was compassionate as well as promoting people’s independence.

People were provided with information about, and or enabled to access, advocacy services when required.

Complaints were investigated in line with the provider's policies and procedures. Complaints were acted upon