This inspection of Cavendish (Homecare) Professionals Ltd was conducted on 25 May and 8 June 2017. Due to the small size of the service and our need to ensure that key personnel would be available, we notified the provider two days before the inspection that we would be coming. At the time of our inspection eight self-funding people were receiving personal care services.

The provider re-registered since the previous inspection so this was our first ratings inspection of the service.

There was a registered manager at the service. 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 registered manager was present on both days of the inspection.

Relatives informed us that their family members felt safe and comfortable with staff and comfortable. Staff understood about different types of abuse that people were at risk from and knew how to report any concerns about people’s safety and welfare. The provider’s policies and procedures for safeguarding clearly stated that need to inform the local safeguarding team about any concerns.

Staff told us they always asked people for their consent before they provided care and support. They understood about the need to support people to make daily choices about how they wished to receive their care and how to uphold people’s legal rights in line with the Mental Capacity Act 2005 (MCA).

People’s needs were assessed before they used the service and individual care plans were developed to reflect people’s health and social care needs, wishes, preferences, and any cultural and/or spiritual needs. Care plans were regularly reviewed and updated as required. Risk assessments were developed to identify and mitigate risks when delivering care and support. Separate risk assessments were in place to address any environmental risks. Safe systems were operated to manage people’s prescribed medicines, where this support was needed.

Relatives stated that there were sufficient staff employed to ensure their family members received a consistent and reliable service. Thorough recruitment practices were used to make sure that newly appointed staff were suitably experienced to work for the service. Staff received training and supervision to carry out their roles, and reported that they were happy with the quality of training and managerial support that they received.

We received positive comments from relatives and external health care professionals in regards to how the agency supported people to meet their health care needs. Staff demonstrated an understanding of how to assist people with their eating and drinking, and they understood the provider’s required protocols to support people who were at risk of poor nutrition and/or hydration.

Staff were described as being outstandingly compassionate, considerate and kind. Staff understood how to protect people’s dignity and privacy, and we received exceptionally complimentary comments from relatives and external health care professionals about how people were cared for at the final stage of their lives.

Relatives and staff reported that the registered manager frequently visited people’s homes to check that they were being supported in accordance with their needs and wishes, as identified in their individual care plans. Following our observation during this inspection that visit reports were not in place, the registered manager had commenced the agency’s new system for recording what occurred on these visits.

Effective practices were employed to inform people and their relatives about how to make a complaint, and the complaints we looked at had been fully and sensitively investigated.

The service was well managed by the registered manager and the manager. Positive views a