We carried out this announced inspection visit on 24 and 27 April 2018.

The service was registered in July 2015. This was our first inspection of the service since it was registered. We contacted the service on 23 April 2018 to arrange our visit because this is a small service and we needed to be sure the registered manager would be available to speak with us and so that we could gain access to the office.

This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to older adults and younger disabled adults. At the time of our visit they were supporting 25 people living in West Cumbria, mostly in the towns of Workington, Cockermouth and surrounding rural areas.

Not everyone using Always Here receives regulated activity; 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.

There was a registered manager employed to run the service. 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 felt safe when receiving care and support from staff. People reported that the service was very reliable and that they had never experienced a missed visit.

Staff knew how to recognise and report potential safeguarding issues and they received appropriate training in this area. Staff were safely recruited having all the appropriate checks to ensure they were suitable to work with vulnerable people.

People told us staff were very friendly, kind and caring and people highly valued the service they received. Privacy and dignity were respected and promoted by the care staff.

Risk assessments were in place to protect people from risks but also enabled them to safely carry on their day to day lives. People reported that staff had helped them to be confident and regain skills to become more independent.

People's human rights were protected because the registered manager and staff had an understanding of

the Mental Capacity Act 2005 (MCA). 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 support this practice.

People were included in planning and agreeing to the care they received. The service offered was flexible to people’s needs. They could ask for changes to their planned care and the service agreed to these where possible.

Staffing levels were sufficient to ensure people received standards of care that enhanced their welfare, safety and day to day living.

Staff told us they felt very well supported by the management team. The care staff were well trained and supported to be able to provide the care people needed, and specialist training was given to meet people’s individual support needs.

Staff received comprehensive induction when they first started work at the service and received on-going supervision and an annual appraisal of their performance. Staff professional development and staff well-being was given a high priority by the organisation.

The service had developed good links with healthcare and social care professionals to support people with their health and well-being. Healthcare professionals spoke highly of the service and the part it played in a team approach to managing people’s healthcare needs in the community.

Medicines were handled safely and people received support with their medicines as they needed. People received the support they needed to prepare meals and drinks.

People felt able, and knew how to make complaints. Where issues had been highlighted by p