This inspection took place on 1 and 2 October 2018 and was announced. We gave the provider 48 hours’ notice as we needed to be sure somebody would be available in the office. The first day of the inspection was spent at the agency’s office and on the second day we spoke with people who used the service on the telephone.

START is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to people who are living with dementia, learning disabilities or autistic spectrum disorder, older people, younger adults and people who have a physical disability and/or sensory impairment. Not everyone using the 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.

At the time of this inspection 15 people were receiving assistance with their personal care needs.

START provides a short-term assessment and re-enablement service (maximum six weeks) to people who are discharged from hospital and to prevent admission to hospital.

This was the agency’s first inspection since it registered with the Care Quality Commission in July 2017.

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.

The registered manager had been in post since September 2018.

People felt safe. People were protected from the risk of harm or abuse because the provider had effective systems in place which were understood and followed by staff. People were supported with their medicines by staff who were trained and competent in their role. There were sufficient staff to meet people’s needs in a safe and unhurried way. The provider ensured staff were suitable to work with people. Staff knew the procedures to follow should they did not get a response when visiting a person’s home. The procedures for identifying and managing risks helped to ensure people were safe.

People received effective care. People were supported by staff who were trained and competent in their roles. People’s health care needs were monitored. 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 supported by kind and caring staff who took time to get to know people and what was important to them. Staff treated people with respect and respected their right to privacy. People were supported to achieve their goals and reach their full potential.

People were involved in planning and reviewing the care they received which helped to ensure people received a service which met their needs and preferences. People’s religious and cultural needs were understood and considered by staff. Information was available in accessible formats where required. There were procedures in place to ensure people had access to the equipment they needed to promote their independence. People knew how to complain if they were unhappy with the support they received.

The registered manager was committed to ensuring people received a high standard of care. The provider had effective systems in place to monitor and improve the quality of the service provided. People were supported by a team of staff who felt supported and valued. People’s views were valued. The registered manager worked closely with other professionals to ensure the best outcomes for people who used the service.