We undertook an announced inspection of Autumn Years on 9 and 10 January 2018.

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 people and younger adults in and around Oxfordshire.

At our last inspection on 18 and 22 April 2016, we asked the provider to take action and operate effective recruitment procedures to ensure that information specified in Schedule 3 was available. These concerns were a breach of regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. On this inspection on 9 and 10 January 2018, we found improvements had been made and the provider was no longer in breach of this regulation.

At the last inspection, the service was rated requires improvement in the safe domain and good overall.

At this inspection, we found the service remained Good overall.

Why the service was rated Good:

People who were supported by the service felt safe. Staff had a clear understanding on how to safeguard people and protect their health and well-being. People received their medicines as prescribed. There were systems in place to manage safe administration and storage of medicines.

The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their roles. There were enough staff to meet people’s needs.

People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where risks to people had been identified, action had been taken to manage the risks. Staff were aware of people’s needs and followed guidance to keep them safe.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.

The service continued to provide support in a caring way. People were involved in decisions about their care needs and the support they required to meet those needs. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People were supported to have access to activities of their choice in the community.

People knew how to complain and complaints were dealt with in line with the provider's complaints policy. People's input was valued and they were encouraged to feedback on the quality of the service and make suggestions for improvements. Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible.

Autumn Years was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos. Staff told us they worked well as a team and felt valued. The registered manager led by example.

The registered manager monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care and support and promote a positive culture that was person-centred, open, inclusive and empowering, which achieved good outcomes for people.

This inspection took place on 18 and 22 April 2016 and was announced. Autumn Years Care provides care and support to people in their own homes. At the time of our inspection 17 people were using the service.

The service was managed by the registered person who is an individual provider. There is therefore no legal requirement for 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.

This was the first inspection of the service. During the inspection, we found there was a breach of one regulation relating to the recruitment of new staff. You can see what action we told the provider to take at the back of the full version of the report.

We received positive feedback about the staff, the culture of the service and its leadership. The manager promoted strong organisational values which resulted in a caring culture that centred on people using the service. The service had recently been recognised for high standards of care, had won a regional award for dignity in care and, was a finalist in a national competition for the provision of high quality care and leadership.

People described staff as respectful, caring and helpful. People and their relatives experienced kindness and consideration during care visits. People were given choices about how and when they wanted their care delivered. Staff knew the people they cared for, understood their individual preferences and what was important to them. People were supported to maintain their health and were referred for specialist advice as required. People were encouraged to remain as independent as possible. Staff understood the importance of promoting independence.

People had a range of risk assessments in place. Associated care plans were personalised and contained detailed information to enable staff to understand people’s needs and how those needs should be met. People were involved in their care and felt listened to.

People felt safe when being supported by staff. Staff told us there was an open culture at the service and were clear about the action they would take to keep people safe. People and their relatives knew how to raise concerns and felt their concerns would be addressed promptly and to their satisfaction.

Staff enjoyed their work and felt supported and valued. Staff were encouraged to develop on a continuous basis. In addition to receiving formal training the service encouraged learning and improvement through fun activities such as a monthly quiz. The manager ensured staff were competent before allowing them to work alone or carry out specialist tasks.

There were enough staff to meet people’s needs. People received their prescribed medicines when they needed them.

The manager looked for ways to continually improve the quality of the service. There were effective quality assurance processes in place to monitor the quality of the service.

People were asked for their consent before care was carried out. The manager and staff were clear on their responsibilities under the Mental Capacity Act 2005 if it was thought a person may lack the capacity to make certain decisions.