This announced inspection took place on 14 November 2017. This was our first inspection of this service since they registered with us.

Choices Care Ltd is a domiciliary care agency which provides personal care to people who live in their own homes in Leicester. They support people with a range of needs, including health conditions and people living with dementia. At the time of our inspection there were 54 people using the service.

There was a registered manager in post. 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 received safe care. Staff had completed training to enable them to recognise signs and symptoms of abuse and felt confident in how to report concerns.

Potential risks people were exposed to had been identified and reviewed. Risk assessments included detailed information and guidance to support staff to follow measures to reduce the risk of harm.

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.

There were robust recruitment processes in place. These helped to ensure staff were suitable to provide care and support. There were enough staff available to meet people's needs as assessed in their care plans.

Systems were in place to ensure staff followed safe infection control procedures to prevent the risk of infection when providing care. People received their medicines safely as prescribed.

There were arrangements in place for the service to make sure that action was taken and lessons learned when accidents or incidents occurred, to improve safety across the service.

People's needs and choices were assessed and their care provided in line with their wishes, preferences and best practice. The care provided was effective and met people's needs.

Staff completed an induction process when they first stated working in the service and on-going development training and supervision. Training was reviewed and evaluated to ensure it was effective. This supported staff to gain the skills and knowledge they needed to provide care based on current practice.

People received enough to eat and drink and were supported to maintain their nutritional health if required. People were supported to access health appointments when required to make sure they maintained their well-being.

Staff demonstrated their understanding of the Mental Capacity Act 2005 (MCA). They gained people's consent before providing care and respected people's right to decline their care.

People had developed positive relationships with staff, who were kind and caring and treated people, their homes and their relatives with respect. Staff understood people's individual needs and preferred means of communicating and this supported people to receive and share information about their care. People and relatives were signposted to agencies who were able to support them in making decisions about their care.

The care staff provided was focussed on each person as an individual. People and, where appropriate, their relatives, were encouraged to make decisions about how their care was provided. Care was provided in a way that supported people to maintain their independence as much as possible, whilst respecting their right to privacy and dignity.

Care plans provided staff with detailed information and guidance about people's likes, dislikes, preferences and guidance from any professionals involved in their care. People and their relatives were involved in planning all aspects of their care and support and were able to make changes to how their care was provided. Records were regularly reviewed to ensure care me