The inspection took place on 5 and 8 October 2018 and was announced. The provider was given 48 hours’ notice as the service provides a domiciliary care service. We wanted to ensure that people were expecting our calls and were available to speak with us.

Bertie & Bells Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It can provide a service to older people, those living with dementia, people who have a learning or physical disability and people who have mental health needs. Not everyone using the service received the regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, which includes help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection there were 53 people who used the service, 32 of whom received the regulated activity of personal care.

Most people funded their own care although one person had their care publicly-funded. The service was registered in October 2017 and is the only service owned by the provider, who was also the registered manager. A registered manager is a ‘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 home is run.

People were asked their consent for day-to-day decisions that affected their lives. However, people were not always supported to have maximum choice and control of their lives. Staff did not support them in the least restrictive way possible. The policies and systems at the service did not always support this practice. This was an area of practice in need of improvement.

People told us that they received a service that made a difference to their lives. Positive relationships had developed between people and staff. Staff took time to get to know people and their preferences. People and their relatives told us that staff were consistently kind, caring and compassionate. One person told us, “They are lovely people, they do anything I want and they are so caring”. Another person told us, “We always have a chat. They are so interested in my family. They’re more like friends than carers. They are very caring”.

People were involved in their care. They were treated with respect and their dignity and privacy was maintained. Staff were introduced to people prior to offering support and people told us that this made them feel comfortable as they knew who to expect once their visits began. People were supported to maintain their skills and independence. Staff supported people to go to the shops, local cafes and the bank.

Care was person-centred and tailored to people’s needs. People and relatives told us about a service that was responsive and adapted to changes in their needs and requirements. Efforts had been made to gather information about people’s backgrounds, their hobbies and interests to provide staff with an insight into people’s lives before they started to use the service. People were supported to maintain their interests and have contact with family and friends.

People told us that they would feel comfortable to raise issues or concerns and that the management team and staff were friendly and approachable. People, their relatives and staff were complimentary about the leadership and management of the service. A relative told us, “They honestly truly do care for their customers. They go the extra-mile and they do a superlative job monitoring my relative. They are obviously caring people, they are doing the job how it should be done. I had contacted a number of companies when I was looking for a care service for my relative. This was the only company that continually focussed on my relative. I knew what I wanted, but they kept going back to focussing on my relative”. Another relative commented, ‘Bertie & Bells is so on the ball and just knocks it out of the