The inspection visit took place on 26 September 2016 and was announced. We gave the provider 48 hours’ notice because the service is a home care agency and the registered manager is often out of the office supporting staff or providing care. We needed to be sure they would be in.

Absolute Care Agency (Barrow) is a home care agency based in Barrow upon Soar in Leicestershire. It supports people who live in their own homes within a seven mile radius of the office.

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.

Care workers spoke in consistently positive terms about the quality of training they received. They told us their training prepared them for the role and gave them a full and comprehensive understanding of the needs of the people they supported. People who used the service told us they felt staff were very well trained and knowledgeable. The provider had a staff training plan that was linked to the strategic aims and objectives of the service. There was a particular focus on ensuring that care workers were supported to understand medical conditions people lived with and how to support them to best lead their lives. People using the service and their relatives spoke in consistently complimentary and positive terms about the effectiveness of staff.

Staff were supported through supervision and appraisal and they valued the support they received. Several staff obtained further qualifications and progressed to more senior positions in the service or to professional positions in healthcare.

The registered manager understood their responsibilities under the Mental Capacity Act (MCA) 2015. Staff had awareness of the MCA and understood they could provide care and support only if a person consented to it and if the proper safeguards were put in place to protect their rights.

Staff understood the importance of people having healthy diets and eating and drinking appropriate amounts of fluids. When they recognised people had difficulties with swallowing they informed people’s GP so that a referral to a dietician could be considered. They also supported people to access health services when they needed them, carrying out additional routines to help people prepare for hospital appointments. They had training about people's medical conditions and were able to recognise if a person's health deteriorated. When people needed it they took appropriate swift action to support the person to access health services.

People using the service and their relatives told us consistently that they held staff in high regard. The registered manager and care coordinator `matched' staff with people using the service which meant people were supported by staff that naturally empathised with them. Staff were consequently caring and knowledgeable about people’s needs. People were supported by the same staff most of the time.

People were involved in decisions about their care and support. They received the information they needed about the service and about their care and support. Relatives of people using the service told us they were kept informed about things that were important to them. They told us the information was clear and easy to understand.

People told us they were always treated with dignity and respect. The registered manager actively promoted values of compassion and kindness in the service.

People contributed to the assessment of their needs and to reviews of their care plans. Their care plans were centred on their individual needs. People knew how to raise concerns if they felt they had to and they were confident they would be taken seriously by the provider. When people expressed preferences about th