This was a first comprehensive inspection which took place on 18 December 2017 and was announced. We gave the manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office to assist us.

Thamesfield at Home is a domiciliary care agency (DCA) based within an apartment complex, in Henley on Thames. The DCA provides personal care and support to people in their own homes. It provides a service to older people, people physical disability, sensory impairments, dementia and younger adults. The Care Quality Commission (CQC) only inspects the service being received by people provided with the regulated activity ‘personal care’; help with tasks related to personal hygiene and eating. Not everyone using the service receives the regulated activity. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing personal care to five people.

The service did not have 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. While the recruitment was ongoing, the interim management team supported us during the inspection. It consisted of two registered managers from two other locations by the same provider, the regional manager, and the director.

People felt safe while supported by the staff. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. Staff had the knowledge and confidence to identify safeguarding concerns and acted on these to keep people safe.

Staff training records indicated which training was considered mandatory by the provider. Most of the staff were up to date with their mandatory training. The manager had planned and booked training when necessary to ensure all staff had the appropriate knowledge to support people. Staff had not always received ongoing support via regular supervision and appraisals. However, they felt supported and maintained great team work. The manager had started improving this by carrying out supervisions with staff according to a new schedule.

People were supported by sufficient numbers of staff to meet their individual needs. People were informed about the changes to and timings of their visits. The provider had an appropriate recruitment procedure to follow before new staff were employed to work with people. They checked to ensure staff were of good character and suitable for their role.

People were treated with respect and their privacy, and dignity were promoted. People said their support workers were good and supported them in the way they wanted. Staff were responsive to the needs of the people and enabled them to improve and/or maintain their independence with personal care. People's health and wellbeing were monitored and appropriate action was taken when required to address concerns. Risks to people's personal safety were assessed and plans were in place to minimise those risks. There were safe medicines administration systems in place and people received their medicines when required.

People received support that was individualised to their specific needs. Their needs and support plans were kept under review and amended as changes occurred. People's rights to make their own decisions, where possible, were protected and staff were aware of their responsibilities to ensure people's rights were promoted.

Staff felt they worked well together and supported each other, which benefitted people. Staff felt management worked with them as a team and they had good communication. The service had quality assurance systems put in place to monitor the running of the service and the quality of