This inspection took place on 25, 28 September and 3 October 2018.

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults.

At the time of inspection, there were three people receiving personal care services from the provider. This was our first inspection of the service.

The service had a registered manager in place at the time of our inspection. 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.

The service was a small domiciliary service which was based in Southampton. The registered manager, who was also the provider took an active role in all aspects of the service. This included, recruiting staff, administration, supervision of staff and delivery of care. They were passionate and dedicated in the role and had a comprehensive knowledge of people’s needs.

The registered manager carried out regular audits of people’s care records and documentation to help monitor the quality of the care people received.

There were enough staff in place to meet people’s needs. The registered manager had overseen safe recruitment practices for staff and had a system of training in place to help ensure staff had the right skills to perform effectively in their role. The registered manager regularly worked alongside staff and monitored their performance through regular feedback and supervision.

People received personalised care. Due in part to the small numbers of staff and people, people had very regular staff, who they told us were caring and compassionate. Staff took time to get to know people and their families and treated them with dignity and respect.

People told us they were involved in planning how their care was delivered. The provider sought appropriate consent to the care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care plans contained detailed information about their preferred routines around their personal care. People told us that staff understood their preferences and respected their choice. The registered manager carried out assessments of people’s needs before starting care to help ensure people’s needs were met.

The provider understood the principles of delivering compassionate and empathic care to people at the end of their lives. They worked with people to identify their preferred care arrangements to help ensure staff could deliver a service in line with their preferences.

Risks to people’s health and wellbeing were assessed and mitigated. Staff made appropriate referrals to healthcare professionals when concerns were raised. The provider had systems in place to ensure a manager was always available to aid people and staff. There were systems in place to record, report and analyse accidents and incidents when they occurred.

The support people needed around their medicines and eating and drinking was identified in their care plans. People were independent in these areas but the provider had detailed this information for staff reference.

There were policies in place to help protect people from abuse and harm. The registered manager understood their responsibilities in reporting significant incidents to CQC. The provider had a complaints policy in place which identified how people could raise concerns. The registered manager was in regular contact with people and their relatives to gain feedback and listen to concerns.

The provider had systems and policies in place to reduce the risk of infections spreading.