We carried out our inspection on 18 August 2016. The inspection was announced.

Total Community Care is a domiciliary care service providing care and support to people with spinal injuries and neurological conditions supporting them to live in their own homes. The office is based in Kibworth Harcourt, Leicestershire. The service provides support to people nationwide. They operated a bespoke model of care which was centred on the individual that received the care and support. At the time of our inspection there were 54 people using the service.

The service had a registered manager. 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 feedback we received from people who used the service, their relatives, care staff and other professionals was consistently positive highlighting a person-centred care provision.

People’s care was planned and designed to meet their individual needs and preferences. The care they received reflected their preferences and was responsive to their needs. This enabled people to achieve positive outcomes in their health and general wellbeing. This also supported them to be active members of society.

People were safe from harm because staff understood their responsibility to keep people safe from avoidable harm. They were knowledgeable about the support that people required to manage their health conditions safely and provided this in a prompt manner.

The provider had robust systems in place to assess and manage the risks associated with people’s care. This guided staff to respond effectively in varying situations and emergencies including relieving people of any discomfort that may be associated with their health needs.

The provider had a person-centred approach to staff recruitment which ensured that people were supported by staff who had the right skills and experience, and met the preferences of people who they would support. There were enough staff readily available to meet people’s assessed needs in a timely manner.

Staff had the relevant skills they required to meet people’s needs effectively. People that used the service were empowered to be involved in training their care staff on their personal requirements for the care that they received. The provider employed specialist qualified staff who supported staff to meet people’s changing needs.

People were supported to be in control of their care packages. They were supported to make their own decisions in accordance with relevant legislation and guidance.

Staff provided people with effective support to manage their health and social care needs. They were knowledgeable about people’s health conditions. They worked proactively with health professionals and ensured that people had prompt access to health services when required.

Staff were kind and compassionate to people. They treated them with utmost dignity and respect. They were empathetic about the needs of people that received round the clock care and ensured that they provided opportunities for people to have privacy. They treated people’s information confidentially and supported people to be independent as possible to minimise risks of intrusion.

People received support that was focused on achieving positive outcomes for them. They were empowered to participate in daily living activities of their choice. The provider ensued that people had the relevant equipment and support that they required to be active members of society.

The provider listened to feedback from people using the service and staff. People told us that staff acted promptly on their feedback.

People were empowered to be involved in the running of the service. The provider had a clear culture that people were at the heart of the serv