The inspection visit took place on the 17 May 2018 and phone calls to people who used the service took place on 16 May 2018. The provider was given 48 hours’ notice of the inspection, as this is a community service where staff are often out during the day and we needed to make sure that the registered manager would be available to meet us. This was a comprehensive inspection and the first inspection since the service was reregistered in April 2017 and since the initial registration in October 2016.

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.

This is a care at home service. It provides personal care to 42 adults living in their own homes in the community. Not everyone using Senescence Care Agency receives regulated activity; 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.

People who used the service were safe from identified risks. The registered manager followed safe recruitment practices and new staff were supported to develop their care skills whilst they completed a robust induction, before they cared for people on a one-to-one basis. Equipment was maintained and used safely to help people to mobilise. Medicines were managed safely, records were audited and staff received relevant training to ensure they had up-to-date knowledge and skills to administer medicines.

The service was very effective at caring for people. The service was developed using evidence based guidance and good practice. This ensured people received person centred care based on up-to-date evidence which promoted their rights and abilities. Staff received specialist training to ensure they understood and were able to meet people’s complex needs. People were supported to eat a balanced diet and had enough hydration to maintain their health and wellbeing. Staff knew people’s preferences for food and applied this when preparing food for people. There was excellent communication across the service, between staff working in the community and office based staff. Information regarding people’s changing health needs was discussed and shared among internal staff team and with external partners when appropriate.

People were supported to access external healthcare services and staff accompanied them when required. This ensured people maintained their overall health and wellbeing. Staff sought consent from people before caring for them and they understood and followed the principles of the Mental Capacity Act, 2005 (MCA). Staff took great care and time to ensure that the views of people with communication difficulties were captured and acted upon. The service was extremely person-centred and the staff were passionate about caring for people, without discrimination.

The staff were extremely caring and motivated to ensure people had the best possible care. They treated people with respect and dignity and developed positive relationships with people based on empowerment, equality and trust. Staff provided a compassionate and holistic service to people that included meeting their emotional and physical needs. People were encouraged to be involved in their care planning and staff made efforts to involve people and gain their views and preferences.

People received very responsive care that was personalised to their particular needs. Staff promoted people’s choices and preferences and supported them to maintain their interests and their place in the local communities. People said any comments or suggestions were acted upon quickly by the registered manager, who used feedback to