The inspection took place on 23 April 2018 and was announced to ensure staff we needed to speak with were available. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults, in addition to people living with dementia, sensory impairment, people who misuse substances, people with a learning disability or mental health diagnosis.

CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. On the day of the inspection, 130 people were being supported with the regulated activity of personal care.

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.

People were safeguarded from the risk of abuse; staff understood both their role and duty to protect people and had access to relevant guidance. A range of risks to people had been assessed in relation to their moving and re-positioning needs, falls, skin care and environment, and measures were in place to manage them. People received their medicines safely from trained and competent staff. People were protected from the spread of infection as staff had undertaken relevant training, which they applied during the course of their work. Processes were in place to investigate incidents and to ensure any relevant learning took place in order to reduce the likelihood of repetition.

Where people’s care had been commissioned by a statutory authority instead of privately purchased, the provider had applied the commissioner’s capacity planning tool to determine the timing of people’s calls. They also took into account their preferences where possible and any identified risks, that impacted upon the required timing of their call. Appropriate pre-employment checks had been completed for new staff.

People’s needs had been assessed with them. The delivery of their care and treatment took into account legislation and good practice guidelines, in order to ensure people received effective care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff received an appropriate induction to their role, on-going training, professional development opportunities and supervision. Staff supported people appropriately to ensure their food and drink needs were met. Staff worked well together, both within the service and with external agencies, to ensure people received effective care. Staff supported people to access healthcare services as required.

People and their relatives reported staff were kind and caring, which we observed. We heard staff as they involved people in decisions about their care and treatment which was also confirmed by people and records. The provider consulted people about their preferences for male or female staff at their initial assessment and endeavoured where practicable to meet their requirements. Staff upheld people’s privacy and dignity during the provision of their personal care.

People received care that was responsive to their needs. Their care planning took into account their strengths and levels of independence. People’s information needs had been identified and met.

People’s complaints had been noted and actions taken, the registered manager hadtaken action to ensure verbal complaints received and the actions taken are added to the central complaints log to enable effective monitoring.

At the end of their lives people received