Braintree Healthcare Limited is a domiciliary care agency which provides support to people with learning disabilities living in their own homes. On the day of the inspection there were 14 people using the service. Due to the complex needs of people using the service a majority of people received 24 hour care form the provider.

This service was last inspected on 22 November 2013 and was found to be compliant with the regulations.

The inspection took place on 17 October 2016 and was announced. The service provided support to people living in their own homes, therefore to ensure that they were at home and to arrange a convenient time for us to visit them the service was given 48 hours’ notice of the inspection.

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.

People who used the service and their relatives spoke of the outstanding care delivery. Relatives told us that the manager and staff went above and beyond what was necessary to ensure that people received a person centred service. People received care from staff who knew and understood them and with whom they felt comfortable. Consequently, meaningful relationships had developed between staff and people using the service, and it was clear that staff enjoyed supporting people and enabling them to achieve their goals. Staff were thoughtful and patient when providing care and supported people to make choices about all aspects of their daily life. Staff were respectful and showed empathy, compassion and kindness when speaking to people. The service supported people to maintain relationships and to access and be an active part of the community.

Risk assessments were in place to protect people from harm. Staff received training on how to recognise signs of abuse and were clear about what action to take if any concerns arose. The service had provided people with information about how to recognise and report concerns about abuse in an easy read format.

The service had a robust recruitment process in place to ensure that staff had the necessary skills and attributes to support people using the service. New members of staff completed an induction programme during which they were given time to familiarise themselves with people’s care plan and were introduced to, and spent time with, the people that they would be supporting.

People received care from highly skilled staff who were supported to access a wide variety of training sessions which ensured that the needs of people using the service were met.

Each person received care that was individualised and centred around their needs and wishes. The care and support provided to people was proactive and was based upon their preferences and passions in life. Support was provided in a flexible way, this meant that it could be adapted to meet people’s changing needs.

People were supported in line with the legislation of the Mental Capacity Act and no unnecessarily restrictive practices were in place. There were effective systems in place to ensure that people’s medication, money and personal information was kept safe. There were also systems in place that recorded, analysed and enabled the service to learn from accidents and incidents.

Staff supported people to understand the importance of a healthy diet and how to maintain a healthy weight. Where concerns were identified about people’s nutritional status specialist advice was sought from healthcare professionals such as the dietician and speech and language therapist.

The service supported people to express their views by having weekly one to one meetings which were recorded in their support plan. People were supported by a regular member of staff who k

During our inspection we spoke with two people who received care and support from the service. They told us that they were happy with the care and support they received. One person told us they were, "Very happy with the care I get, I have no problems." They told us that staff helped them with day to day tasks, and made sure that they could go out to places they liked to visit.

We looked at care records. These were clear and showed the involvement of the person they related to. We also looked at staff training records. These showed that the care staff received a range of training to ensure they had the necessary skills to support and care for the people that received support.

We reviewed the provider's quality assurance process. This ensured that any required improvements were identified and introduced.

We visited both of the houses in the community where people were receiving care and support in their own home. Those people with whom we spoke confirmed that they were happy with the support and care provided by this service. They also reported that they were happy with how the service meets their individual care and welfare needs. Two people reported that they had enjoyed their holiday away from the home.

We spoke with two people who used the service and one relative about the service received from Braintree Healthcare Ltd. All told us that they were happy with the service received. We observed that people were supported by staff who were caring and kind and knew all aspects of their care needs. One person told us, “I like it here, I go out most days now.” A relative told us, “The care provided is good; I can sleep at night knowing my (relative) is supported by the service.”

We found that people’s needs had been planned and assessed to meet their needs. We observed and saw through records that the care received by people was safe. We found that the service had appropriate arrangements in place for obtaining consent to care. Where appropriate the service had assessed people’s mental capacity in accordance with the Mental Capacity Act 2005.

The provider had good arrangements to promote effective performance of the service. People were asked to provide feedback about the care they received and were supported appropriately. Where improvements could be made the manager had a clear plan in place to ensure the improvements were achieved.

We saw that the registered manager showed clear leadership and that all staff were expected to provide a high quality of care to people. The provider ensured that people’s care was regularly reviewed and that additional provisions to support their care were provided where required.