This inspection took place on 25 June 2018 and was announced. We gave the provider prior notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

ACASA is a domiciliary care agency that provides personal care to people in their own homes. It provides a service to people who misuse drugs and alcohol, have dementia, an eating disorder, learning disabilities or autistic spectrum disorder, mental health, physical disability, sensory impairment, as well as older people and younger adults.

ACASA also had a service called REACT Reablement which is a service working with the local authority to offer an intensive period of support for people in their own homes. Reablement staff work with individuals to support them to re-learn skills and build confidence they need to reach their maximum level of independence.

The Care Quality Commission (CQC) only inspects the service being received by people provided with the regulated activity ‘personal care’; help with tasks related to personal hygiene and eating. Not everyone using the service receives the regulated activity. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing personal care to 120 people.

The service had a registered manager in place. 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 registered manager supported us during the inspection. This was the first inspection since provider registration changes.

People felt safe while supported by the staff. Relatives agreed the staff supported their family members appropriately and made them feel reassured. Staff had a good understanding of how to keep people safe and their responsibilities for reporting accidents, incidents or concerns. Staff had the knowledge and confidence to identify safeguarding concerns and acted on these in a timely manner.

People were supported by sufficient numbers of staff to meet their individual needs. Where possible, the registered manager scheduled visits so the same staff went to see people to maintain continuity of care and support. People were informed about the changes to their visits as necessary. The service had an appropriate recruitment procedure that they followed before new staff were employed to work with people. They checked to ensure staff were of good character and suitable for their role.

People were treated with respect, and their privacy and dignity were promoted. People and relatives felt the staff supported them in the way they wanted. Staff were responsive to the needs of the people and enabled them to improve and maintain their independence with personal care.

Staff training records indicated which training was considered mandatory. The registered manager and senior staff had planned and booked training when necessary to ensure all staff had the appropriate knowledge to support people. Staff had ongoing support via regular supervision and appraisals. They felt supported by the registered manager and maintained great team work. People and relatives were very complimentary of the staff and the support and care they provided.

People received support that was individualised to their specific needs and were kept under review and amended as changes occurred. People's rights to make their own decisions, where possible, were protected and respected. Staff were aware of their responsibilities to ensure people's rights were promoted.

The staff monitored people's health and wellbeing and took appropriate action as required to address concerns. People and relatives felt confident they would be looked after well. Professionals agreed the service worked well with othe