This inspection took place on 30 January and 6 February 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.

Berkshire Care Limited is a domiciliary care agency that provides personal care to people in their own homes. It provides a service to older adults, younger disabled adults, and people living with dementia, physical disability and sensory impairments.

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 nine 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.

On the first day we met administration staff who were overseeing the service while the registered manager was away. On the second day of inspection, we met the registered manager to continue carrying out the inspection.

At our last inspection we rated the service Good with Caring domain rated Outstanding. At this inspection we found the evidence continued to support the rating of Outstanding in the Caring domain. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe while supported by the staff. 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 to keep people safe.

Staff training records indicated which training was considered mandatory. Most of the staff were up to date with their mandatory training. The registered manager had planned and booked training when necessary to ensure all staff had the appropriate knowledge to support people. We have made a recommendation the registered manager refer to the current best practice guidance on ongoing training for social care staff.

Staff had ongoing support via regular supervision and appraisals. They felt supported by the registered manager and maintained great team work.

People were supported by sufficient numbers of staff to meet their individual needs. People were informed about the changes to and timings of their visits. The service had an appropriate recruitment procedure to follow 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 supported by a dedicated and caring team of staff and the registered manager, helping them to build and maintain their independence and live their life to the fullest. The service went above and beyond their role to enable people to develop and meet their personal goals and wishes. People were treated with the utmost respect and their privacy, and dignity were promoted. People and relatives felt their care workers were excellent and supported them in the way they wanted. Staff were very responsive to the needs of the people and enabled them to improve and/or maintain their independence with personal care. The whole staff team were highly motivated and proud of the service they provided to the people.

The staff monitored people's health and wellbeing and took appropriate action when required to

Berkshire Care Limited is a small domiciliary care agency which provides support to people in their own homes. At the time of our inspection Berkshire Care Limited was providing support to 17 people.

This inspection took place on 20 November 2015. The inspection visit was announced 48 hours in advance because the location provides a domiciliary care service and we needed to be sure that a member of the management team could be contacted in person on the day. The service had been previously inspected in May 2013 when it had been found to comply with the requirements of regulations.

The service was operated from an office on the first floor of a building. The office was accessible via a passenger lift and accessible toilet facilities were available.

There was a registered manager in post. 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 told us they felt safe when they received care and support from staff employed by the service. Staff were aware of their responsibilities to report any safeguarding concerns they may have.

Recruitment systems were effective as pre-employment checks were carried out. Staff had received a full induction to understand their role and to ensure they had the skills to meet people’s specific needs. As a result, people could be confident they received care and support from staff who were competent and well matched to their position.

The service’s induction programme was robust and included mandatory training and a requirement for staff to read the company’s policies. The training was on-going and comprehensive; staff told us they could access training whenever it was needed.

People’s consent was sought when appropriate and the service worked within the requirements of the Mental Capacity Act (2005) (MCA). The service ensured they worked in people’s best interests.

We also observed that people’s nutritional needs were assessed and adhered to. Other services and agencies, such as health professionals, were accessed when required.

Staff were caring and treated people with dignity and respect. People’s independence was respected and promoted, and staff responded to people’s support needs. They had gone above and beyond their duty providing people with care. Staff had not hesitated to devote their own time to attending training in order to speed up the process of discharging a person from a hospital. What is significant, their commitment had not been restricted to the singular action. Staff had constantly put a lot of effort into providing care to people, not for benefits, but often at the expense of their own time. For example, they had supported people voluntarily after they had been discharged from a hospital.

Both people who used the service and staff told us the management were approachable and supportive. Staff had regular supervision sessions where they could raise any issues or concerns. Team meetings were held on a six monthly basis to provide a forum to discuss practice issues and disseminate information.

The registered person and manager had completed regular quality checks. The service was run in an open and inclusive way that encouraged staff to contribute to its development.

The registered manager was seen as a good leader, both by staff and people using the service. The manager was trusted and had instilled a strong sense of commitment in staff by motivating, encouraging and supporting them in making continuous efforts to meet people’s needs.