This announced inspection took place on 31 January 2017. Access Offices is a domiciliary care service and provides care and support to people in their own home. There were 90 people using the service at the time of our inspection. This is the first inspection of Access Offices since their registration with the Care Quality Commission in August 2016.

The service had a registered manager. 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.

Staff knew how to keep the people they supported safe. They had received training in protecting people from abuse and understood their responsibility to report any concerns. There were processes to minimise risks to people’s health and well-being. Risks were identified and managed well. The provider used appropriate systems to carry out checks of the suitability of staff to work with people who use the service. There were sufficient numbers of staff to support people.

People received the support they required to take their medicines. Staff were competent to manage and administer people’s medicines safely.

Staff described the registered manager as approachable and supportive. They received an induction when they started working for the service and completed training to support them in meeting people’s needs effectively. Staff received regular supervisions and an appraisal and used feedback to improve their practice. People were supported to access healthcare services as required. They received the support they required with eating and drinking.

People were placed at the centre of decisions made about the care and support they received. Staff knew people well and understood how to respond to their individual needs. Information about people and assessed risks was available for staff to refer to in their care plans. Care plans were person centred and written with the person's involvement. There were support plans in place to guide staff on how to support people in line with their needs and identified risks. People were involved in the regular reviews of their care. People were supported to remain as independent as they were able.

The registered manager and staff understood and supported people in line with the principles of the Mental Capacity Act 2005. People who may lack mental capacity were given appropriate support to understand and make decisions relating to the care and support they required. People’s consent was sought prior to care being provided. Staff demonstrated kindness and compassion towards the people they supported.

People and their relatives knew how to raise concerns or make a complaint if needed. Records showed complaints were investigated and resolved in a timely manner in line with the provider’s policy.

The registered manager had a clear vision for the service which staff understood and shared. There were systems to monitor and review the quality of service people received and to understand the experiences of people who used the service. This was through regular communication with people and their relatives, annual quality surveys and audits undertaken at the service. Suggestions for change were listened to and actions taken to improve the service.