We inspected Top Carers on 13 March 2015. The inspection was announced 48 hours in advance because it is a small service and we needed to ensure the provider or registered manager was available.

We previously inspected Top Carers August 2013 and the service was found to be meeting all the regulations we inspected.

Top Carers is a service which is registered to provide nursing and personal care to adults in their own home. At the time of our inspection there were six people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.

People told us they were safe. This was also the view of their relatives. Care was planned and delivered to ensure people were protected against abuse and avoidable harm. Staff arrived on time and stayed for the allotted time. People were cared for by a sufficient number of suitable staff to keep them safe and meet their needs. There was continuity of care and staff understood people’s needs.

People were protected from the risk and spread of infection because staff understood their responsibilities in relation to infection control and followed the procedures in place.

People were cared for by staff who had the necessary experience and knowledge to support them to have a good quality of life. Staff understood the relevant requirements of the Mental Capacity Act 2005 and how it applied to people in their care

People were treated with respect, compassion and kindness. People’s individuality was at the centre of how their care was delivered. They were fully involved in making decisions about their care. Where appropriate their relatives were also involved. People were supported to express their views and give feedback on the care they received.

People received the help they needed to maintain good health and had access to a variety of healthcare professionals.

The registered manager understood what was necessary to provide a quality service and had a variety of systems in place to regularly check and monitor the quality of care people received.

People who use the service understood the care and treatment choices available to them. People told us that staff respected their dignity and privacy and helped maintain their independence. One person told us, "they give me as much or as little help as I need."

We reviewed people’s care files and found that people’s needs were assessed and care and treatment planned and delivered in line with their individual care plan. People's care, treatment and support was planned and delivered to ensure their welfare and safety. People told us they were happy with the way in which care was delivered.

We found that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff received regular training in safeguarding vulnerable adults and had a good knowledge about the types and signs of abuse.

There were effective recruitment and selection processes in place and comprehensive checks were carried out before staff began work. We found that people were cared for by staff who were supported by the service to deliver care and treatment to people safely and to an appropriate standard.