We carried out an unannounced inspection on 15 September 2016. Between this date and 30 September 2016, we spoke with people who used the service, relatives and members of staff by telephone.

The service provides personal care to adults and children with a variety of care needs in their own homes. Some of the 50 people being supported by the service at the time of the inspection were living with dementia.

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.

There were risk assessments in place that gave guidance to staff on how risks to people could be managed. There were systems in place to safeguard people from risk of possible harm and suitable equipment was in place so that people were supported safely. People’s medicines were being managed safely.

The provider had safe recruitment processes in place and they had sufficient numbers of staff to support people safely. Staff had received regular supervision and support, and they had been trained to meet people’s individual needs.

Staff understood their roles and responsibilities to seek people’s consent prior to care being provided. Where people did not have capacity to consent to their care or make decisions about some aspects of their care, this had been managed in line with the requirements of the Mental Capacity Act 2005 (MCA).

People were supported by kind, caring and respectful staff. They were supported to make choices about how they wanted to be supported. People’s health and wellbeing was promoted, and they were supported to access healthcare services when urgent care was required.

People’s needs had been assessed and their care plans took account of their individual needs, preferences, and choices. The provider had a formal process for handling complaints and concerns. They encouraged feedback from people who used the service and their relatives, and they acted on the comments received to improve the quality of the service.

The provider had effective quality monitoring processes in place and these had been used effectively to drive continuous improvements. Most people described the service as ‘very good’. They had no concerns about how their care had been managed and they found communication with office staff to be mainly good.

When we inspected Abacus Care (Beds, Herts & Bucks) Limited on 19 August 2013, we found people had detailed care plans and risk assessments in place. These provided staff with guidance for care delivery and promoted continuity of care.

The staff we spoke with during this inspection were knowledgeable about the people they provided care and support for. We looked at training and staff support records, which confirmed that staff performance and competency was monitored and managed effectively by the provider.

We spoke with three of the 11 people who received personal care from this service, or where more appropriate, their relative. We found all were very satisfied with the service they received. They all spoke highly of the staff that provided their care, and said that the manager was always available if they had any concerns. The relative of one person said. "--- thinks they're the best thing since sliced bread, and I can't fault them either."

The provider had systems in pace to monitor the quality of service provision.

When we inspected Abacus Care (Beds, Herts & Bucks) Limited on 19 October 2012, they were providing regular care and support to approximately 25 people in their own homes. We looked at three care files, and spoke with six people who used the service and their relatives. We found that people were generally very satisfied and happy with the care and support they received. The relative of one person said "We're very lucky, the care is fantastic."

We noted from the three care files that we looked at, that people were offered support at a level which encouraged independence and ensured that their individual needs were met. People told us that the staff were polite and courteous in their approach and were knowledgeable and confident in their roles. One person told us, "I get on very well with my carer". Someone else said "The girls know what they are doing, I have no concerns at all".

We could see from records that people were encouraged to express their views, and were involved in planning and making decisions about their care and support. The provider welcomed suggestions from people which could improve the service they provided. People told us that they felt able to approach the manager to discuss anything, and they were confident that action would be taken swiftly to resolve any issues they had.