This inspection was announced and took place on 18 October 2016. The service was given 48 hours’ notice of the inspection because we wanted to make sure we would be able to speak with staff and people who used the service.

The last inspection of the service was carried out in November 2013. No concerns were identified at that inspection.

CTS Domiciliary Care provides personal care and support to people living in their own homes. The service specialises in the care of people who may have learning disabilities, autism, mental health needs, acquired brain injury, and who may also display behaviour described as challenging. At the time of this inspection the service was supporting three people. Packages of care varied from seven hours a day to 24 hour support.

There is no registered manager in post. However the manager of the service had begun the process of registering with the Care Quality Commission. 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 well led by a management team who were very person centred and supported their staff well. The management team sought people’s views and took action to address any issues raised.

People were supported by a stable staff team and the provider was committed to staff retention to make sure people received consistent care and support. People had been able to build relationships with staff and were very relaxed and comfortable with the staff who worked with them. People told us staff were always kind and caring. A relative said they thought staff went “Beyond the call of duty.”

People had their needs assessed and met by a staff team who received the training they needed to effectively support people. The provider’s clinical team was available to make sure people’s complex health and emotional needs were met in the least restrictive way.

Staff were conscientious and reliable. People told us they were always supported by staff they knew and staff always arrived at the correct time. Staff were flexible which meant people were able to decide on a daily basis what things they wanted assistance with and what they wished to do. One person told us “Everything is my choice.”

People were supported to manage their complex behaviours and make choices about all aspects of their lives. People were fully involved in planning their care and had opportunities to make changes to their care plans. Staff helped people to pursue their hobbies and interests including accompanying people on holidays.

There were systems in place to make sure risks to people were assessed and managed to promote their safety and well-being. People’s medicines were safely administered.

People’s privacy was respected and staff were very clear that they were in someone’s house not in an ordinary workplace. One member of staff said “Obviously it’s their home not mine so they are in charge.” Where people received 24 hour one to one support staff told us how they made sure people were able to spend time alone whenever they wished to. This demonstrated a respect for people to have personal space whilst ensuring their safety.

The agency is a supported living service and provides support with personal care and social support. The service is currently supporting two people. One person agreed to speak with us and we used a home visit to them to gain their views about the service. We spoke with two senior support workers who were present during the home visit and the manager at the time of our visit to the office.

The person we spoke with gave positive feedback about the service and said that support workers respected their choices about the way support was delivered. They described the service as being “brilliant” and “fantastic”.

They told us they felt safe using this service and knew what to do if they had any concerns. They confirmed they had been visited by the agency manager to review the support they were receiving and to check if there were any issues.

The person we spoke with confirmed the support workers encouraged them toward being independent. They told us the support workers asked them about what they wanted and acted in accordance with their responses. They said they were confident the support workers had the appropriate knowledge and skills to meet their needs. We were told “ they are very well trained”.

We visited CTS Domiciliary Care on 25 November 2011 and spent time meeting and talking with people that CTS support and looking at their records. We also talked with members of management and care staff.

CTS Domiciliary Care looked after four people who had care and support delivered in their own homes. We met and talked with two of these people and with seven management and support staff from the organisation.

The people we met and talked with told us that they "really like the service. They look after me really well" and the service was "brilliant". Staff told us "this is a fantastic place to work" and "we have a great team who are amazing" and "I am immensely proud of what we do."

We have found the service compliant with all the essential standards we inspected.

We visited the CTS Domiciliary Care office and spoke with the manager and two senior support workers. We also visited two of the three people who used the service and spoke with the staff who were supporting them. One person told us "the staff are lovely" and we observed that the support provided was responsive to the person's needs and wishes.

Another person told us "I respect the staff and they respect me" and "this is the best service I've been to."

We saw that people had comprehensive care documentation that supported them to be independent and make lifestyle choices.

We found that the provider had appropriate processes in place to support people to manage medication.

The staff team were trained and supervised to provide appropriate care to people who used the service. We heard "the staff are fantastic" and "staff help me but don't do everything for me."

People were made aware of the complaints system. People’s complaints were fully investigated and resolved to their satisfaction.We saw the complaint process was provided in an appropriate format to ensure people understood their rights.