This was an announced inspection carried out on the 29 September 2016.

The service is registered to provide personal care to people within their own homes who lived in the three counties of Shropshire, Herefordshire and Worcestershire. The office is located Tenbury Wells, with adequate parking facilities.

The service has 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.

This service was last inspected in January 2014, when we did not identify any concerns with the care and support provided to people who used the service.

People were protected from the risk of harm and abuse by staff who knew how to recognise and respond appropriately to any concerns that they had.

People were protected against the risks of abuse, because the provider had robust recruitment procedures in place.

Risk assessments were in place to keep people safe within their own home. These provided guidance to staff as to what action to take to reduce the risk of harm.

There were sufficient numbers of staff available to meet people’s needs and keep them safe.

The provider had safe systems in place to manage medicines.

People were supported by motivated staff who had received training and guidance to meet their individual needs.

People’s nutritional needs were routinely assessed, monitored and reviewed.

The provider supported people to access health professionals to ensure they received effective treatment to meet their specific needs.

Staff were professional, kind, caring and had developed positive relationship with people.

Staff were concerned for people’s wellbeing and responsive to their needs.

Care and support was planned in full consultation with people and their relatives.

The provider promoted an open culture, was person centred, inclusive, open and transparent.

The service was involved in both the local community and had developed working relationships with local health care professionals.

The provider had clear arrangements in place to monitor, manage and improve staff practice.

We spoke with 12 people who received a service or their relatives. Everyone we spoke with was very happy with the service they received. They described it as, “Fantastic” and, “Really good”. They also told us that the staff were, “Really good quality”. Relatives of people using the service were also complimentary about it. They told us that the staff were, “Very flexible”, “Very reliable” and, “Excellent”.

We found that people’s views and choices were listened to and respected. People were actively encouraged to participate in the planning and delivery of their support packages. We found that care plans were person centred and very well organised. The plans contained lots of up to date information to help staff deliver good consistent care.

We found that the provider carried out all the necessary checks on new staff before employing them. Staff we spoke with told us that they were well supported in their roles.

The provider regularly monitored and audited its own performance to ensure that it maintained and improved the quality of its service.

People told us that they were extremely happy with the service they received. They said it was, “Excellent”, “Very good”, and “I can’t fault it”. One relative described the service as, “Exceptional”.

Everyone we spoke with was very complimentary about the staff. People told us that they were, “Lovely and friendly” and, “Perfect”.

We found that care plans were detailed and gave staff all the information they needed to provide care and support to people. People’s needs and preferences were clearly recorded and staff had a good knowledge of each person they cared for.

People told us that they had been involved in discussions about the care and support they received. They told us that their views were listened to and respected.

People told us that they felt safe with the staff in their homes. One person said, “I trust them like my own daughter”. People knew who to talk to if they had any concerns. They were confident that their concerns would be taken seriously.

Staff told us that they were very well supported by the management team. We found that staff training was comprehensive and up to date.

We found that the provider regularly reviewed its own services to ensure that it maintained or improved the quality of the care and support it delivered.