The inspection took place on 8 May 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 in the community. This service also provides care and support to people living in 12 ‘extra care’ houses, which are adapted single household accommodation. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

The agency provides a service to younger adults, older people, people living with dementia, people with learning disabilities or autistic spectrum disorder and people with a mental health diagnosis. They also provide care to people who misuse drugs and alcohol, people with an eating disorder, people with a physical disability or sensory impairment. The service provides care to 60 people, at the time of the inspection nineteen of these people received the regulated activity of personal care, therefore only their care was included within the scope of this inspection.

The service had a registered manager this 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.

Staff had undertaken relevant safeguarding training and understood their role to protect people from the risk of abuse. Potential risks to people had been identified, assessed and measures were in place to minimise the risk of their occurrence. People received their medicines from competent, trained staff. Relevant processes and procedures were in place to ensure people’s medicines were managed safely. People were protected from the risk of acquiring an infection. Processes were in place to review incidents and to identify any changes or learning required for people.

The provider operated robust recruitment procedures to ensure staff’s suitability to work with people. There were sufficient staff numbers of staff deployed to meet people’s needs and flexibility if people required additional care. Staff underwent an induction to their role and received on-going training appropriate to their role. Most staff had also achieved a professional qualification in social care.

Staff completed pre-admission assessments with people to determine if they could meet the person’s care needs. Staff had access to information about current standards, legislation and guidance to enable them to provide people with effective care.

Staff worked with a range of other statutory and non-statutory agencies in the provision of people’s care. Staff supported people to live healthier lives and to have access to healthcare services. People were supported where required to ensure they ate and drank sufficient for their needs.

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.

People reported they enjoyed positive, kind relationships with staff. Staff understood how to build relationships with people and spent time with them. People were encouraged to participate in making decisions about their care. People’s privacy and dignity were respected and promoted in the provision of their care.

People reported the service was responsive to their needs. People had care and support plans in place that identified their care needs and how these were to be met. Staff understood people’s care needs. Staff recognised that people living with a mental illness could find it more difficult to have a structure to their day or might experience social isolation and act