This inspection took place on 13 March 2017 and was announced. We gave the registered manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

START is a domiciliary care service providing personal care to people in their own homes. At the time of our inspection there were 12 people using the service. START stands for Short-Term Assessment and Reablement Team. The START Team is part of the Wokingham Integrated Social Care and Health Team (WISH). Working with other members of the WISH team, START's stated aim is to promote the wellbeing of adults with care and support needs. The service aims to help people regain their independence so that they can manage everyday activities as far as possible. There are two aspects to the service:

1. Assessment, which usually takes between one day and two weeks. This is a limited period of care and support during which time the team will help people identify any long-term care needs.

2. Reablement, this service is usually provided for up to six weeks. The focus is on enabling people to retain or regain their skills and confidence so that they can return to being as independent as possible in their own homes.

The service had a registered manager as required. A registered manager is a person who has registered with the CQC 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 was present and assisted us during the inspection.

People were treated with respect and their privacy and dignity was promoted. People and their relatives said the care workers were kind and caring. Staff were responsive to the needs of the people they supported and enabled them to retain and regain their independence as much as possible.

People were protected from risks to their health and wellbeing and were protected from the risk of abuse. Safe recruitment practices were followed before new staff were employed to work with people. Other required checks were made to ensure staff were of good character and suitable for their role.

Staff received training and supervision to enable them to do their jobs safely and to a good standard. The registered manager was in the process of sourcing additional training in topics relevant to the specific work of staff within the service. For example, training in reablement had been arranged for staff to help them build on their skills when delivering the service.

People received support that was individualised to their specific needs. Their needs were monitored and care plans reviewed weekly or as changes occurred. People's rights to make their own decisions, where possible, were protected and promoted by staff.

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.

Medicines were managed well and staff handling medicines were only allowed to do so after completing their training and being assessed as competent. The majority of people who use the service had retained their independence with handling their medicines. Where this was not the case, support was provided towards helping them regain independence where possible.

People benefitted from receiving a service that was managed well. Quality assurance systems were in place to monitor the quality of the care and support being delivered and the running of the service.