This was an unannounced inspection which took place over two days on the 13 and 14 September 2016. Orchard Trust Domiciliary Care Agency provides personal care for people with a learning disability living in their own homes in Gloucestershire. At the time of the inspection ten people were receiving shared care living together in two houses in Lydney.

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.

People received a service which was highly individualised reflecting their personal wishes, aspirations and routines important to them. They had been fully involved in all aspects of their care and support. People had been involved in developing their care records and reviewed them with staff making sure they continued to keep up to date with their changing needs. They had copies of easy to read care plans and other information had been made available to them in formats appropriate to their needs using photographs and pictures. People were supported to be independent around their home and in their local communities. They were helped to gain skills to live independent lifestyles whether managing their own medicines, cooking, cleaning or gaining the confidence to try other types of care and support. People’s days were busy doing meaningful activities of their choice.

People were supported by staff who had been through robust recruitment procedures ensuring all checks had been completed before they started working without supervision. People had been involved in the recruitment of staff. There were enough staff employed to meet people’s needs and to provide flexible cover which reflected people’s lifestyles. Staff had a good understanding of people’s needs. They were responsive to accidents and incidents making sure people had access to health care professionals if needed to keep them safe and well. Staff encouraged people to make decisions and choices about their day to day lives. If decisions needed to be made in people’s best interest this had been done in line with the recommendations of the Mental Capacity Act 2005.

People’s views and those of their relatives, staff and professionals involved in their care were sought as part of the quality assurance process. Feedback included, “Excellent service”, “Staff are very supportive and caring” and “People have a fantastic lifestyle.” The provider had systems in place to monitor and audit people’s experience of their care and support. Staff said the management team were open, accessible and very supportive. Managers and representatives of the provider attended local networks ensuring they kept up to date with best practice and changes in legislation.

We spoke with four people who use the service and reviewed the care records of four people. The records that we saw contained full and comprehensive assessments that had been personalised to people's needs. One person who used the service told us "I've been really well supported".

We saw that medicines were managed safely and that staff were trained to handle medicines.

We saw the training records and the training plan for staff. We spoke with two members of staff and one told us "the training is really good", and we saw evidence that staff were supported to perform their role.

We saw how the manager monitors the quality of service provision and how they sought feedback from people who use the service.

People were asked for consent by staff supporting them. When one person said they would “rather manage their own medicines”, staff had completed a ‘self administration assessment’ with them and had agreed how their medicines would be stored safely.

Staff demonstrated understanding of people’s needs and gave examples of how they worked with individuals to promote their independence within their homes and the local community, while keeping them safe. People told us that they felt safe when supported by staff and they would be happy to talk to them if they had a problem. We observed that people were relaxed and confident in their interactions with staff and spoke openly with them. One person said “I just like living here. It’s better than where I used to live”. They also said they liked staff and that there were always enough of them to look after them.

Systems were in place to monitor the quality of the service people received.