The inspection took place on 23 March 2016 and was announced.

We gave the provider 48 hours notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their homes; we needed to be sure that someone would be available at the office. A registered provider was in charge when we inspected the service. Registered providers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. This service was not required to have a registered manager in post. The service supported 24 people with care in their home when we inspected.

People told us they felt safe with staff in their home. People were familiar with the staff supporting them. Staff understood the signs of abuse and understood what needed to be done in order to raise their concerns. The registered provider also understood their obligations and ensured staff training on the subject was up to date. Staff understood the health conditions people lived with and the associated risks to their health. Staff knew the symptoms to look out for and what action need to be taken. Staff followed recruitment processes that included background checks to assure the registered provider of their suitability to work at the service. People were supported by the correct number of staff and staff attendance at calls was monitored by the registered provider. People’s support to take their medicines was also monitored and any anomalies were highlighted to staff to minimise any reoccurrence.

People received care and support from staff who were regularly supervised and who could discuss people’s care and clarify anything they required support on. Staff used supervision meetings to have open discussions and identify areas of further development if they were needed. Staff training was monitored, so that people benefitted from staff that had up to date training. People were involved in their care so that their consent was obtained and they understood what staff were doing. Staff understood the importance of obtaining a person’s consent and benefitted from training on the subject. The registered provider understood the requirements of the law and acted accordingly. People were given choices about the meals and drinks prepared for them. Staff knew people’s preferences and ensured people received the food they liked and had access to drinks before they left. If people required support to access further medical help, staff recognised what needed to be done to ensure the person received this.

People’s care needs were updated regularly and people’s preferences were known and understood by staff. People were familiar with care staff who regularly attended their calls and felt this helped because it enabled people to gain continuity from staff. People’s privacy and dignity were respected in ways that were important to them. Staff understood each person’s background and about things that were important to them. People knew who to complain to and the process for raising complaints. The registered provider had a system for recording and responding to complaints.

People knew the registered provider and were familiar with them. Staff felt supported and understood they could raise any issue they needed to with the registered provider. The registered provider assured themselves of the quality of care being delivered by sharing some of the care calls. This was supplemented by spot checks and satisfaction surveys. People’s records were also regularly reviewed to ensure people’s needs were correctly documented for staff to refer to.