Best At Home Domiciliary Care Services Limited was inspected on the 21 April 2017 and the visit was announced. This was the service’s first inspection since registering with the Care Quality Commission in May 2016.

Best At Home provides personal care to people living in their own homes. They currently provide personal care to ten people. The provider generally takes referrals from the Clinical Commissioning Groups (CCG’s) and offers personal care to people who are nearing the end of their life. The provider also accepts other groups of people who need personal care although this currently represents a small number of people.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

Care workers knew how to keep people safe from harm and what action they should take if they considered anyone was at risk. Where the service had identified risks to people, they put measures in place to minimise them and help prevent re-occurrences. The provider undertook a number of checks prior to employing new staff to make sure only suitable staff were employed.

Care workers received training and support to make sure the care they provided was in line with best practice and met people’s needs. They sought consent and knew how to maintain people’s privacy before providing personal care.

People told us the registered manager was approachable and if they had any issues or concerns they would be able to raise them, and that they would be listened to and taken seriously. The registered manager undertook a range of checks and audits to continually monitor the quality of the service.

The provider worked carefully to ensure there was continuity of care with the same care workers visiting people. Support plans were reviewed regularly so they reflected people’s changing needs.

The provider routinely monitored people’s health, which included ensuring people were getting enough to eat and drink. People received their medicines safely.

The registered manager understood the people they worked with were nearing the end of their lives and needed particularly sensitive and compassionate care. They also understood the impact this work could have on care workers and therefore offered additional support to them. The registered manager was aware of their responsibilities to inform CQC of significant events.