This announced inspection was carried out on the 9 and 10 May 2018.

Danny’s Dream is a domiciliary care agency owned by Goodwin Development Trust. The agency provides personal care to a range of young and older adults who have learning disabilities and/or complex health needs living in their own homes. A mixture of domiciliary care and social support is offered. The service also provides a 'club' for people receiving a service to use, which was included in most people’s care packages funded by the local authority or health service. At the time of our inspection 30 people were using the service, 17 of those were receiving the regulated activity of personal care.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

There was a manager employed by the service, and they were in the process of submitting their application for 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.

At our last inspection in August 2015 we rated the service as good in safe, effective, caring and well led with outstanding in responsive. This gave an overall rating of good. At this inspection we found the evidence continued to support the previous ratings of good in safe, effective and well led, with outstanding in responsive. Caring had also now improved to outstanding. This means the service’s overall rating is now outstanding.

Danny’s Dream was run with people at the heart of the service. It continued to be outstanding in the way it responded to people's changing needs and put people first at all times. Staff worked collaboratively with other professionals to ensure people received care that enabled them to live as full and independent a life as possible.

The culture of the service was designed around person centred care and valuing people. We found the manager and staff team had continued to develop creative ways in ensuring people had access to a range of activities within the club and in the wider community.

The service was exceptionally caring. People using the service, their relatives and healthcare professionals spoke extremely positively about the caring and compassionate nature of the staff. People and their staff had developed highly positive and caring relationships that took into account people's individual needs and interests. The manager and staff were very proud of the support they provided and the positive outcomes that people had achieved.

Systems were in place that helped keep people safe from harm and abuse. People told us they felt safe. Where risks were identified, action had been taken to manage them for people's safety. Staff were recruited safely and there were sufficient staff to meet people’s needs. People received their medicines safely from trained and competent staff.

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 at the service supported this practice.

Staff received training and supervision to support them in their role and attended some team meetings to share and receive information. Staff told us they felt supported by the management team.

Staff supported people to eat and drink sufficient for their needs. Staff worked both together within the service and across organisations to deliver people's care and treatment. People were well supported by staff with their healthcare needs.

Staff respected people and their homes and encouraged people to uphold their independence wherever possible. Staff understood peop

Danny's Dream is a domiciliary care agency owned by Goodwin Development Trust. The agency is located in The Goodwin Club, ‘Danny’s Dream Club’, which is on Walker Street close to Hull city centre. It is close to local amenities and has easy access to public transport. The service offers a combination of domiciliary care and social support primarily to people who have learning disabilities and/or complex health needs. Danny’s Dream provided a club, the use of which was built into most people’s care package funded by health or the local authority. The club had been adapted to meet people’s needs; it was easily accessible to people who used wheelchairs to mobilise and had wide toilets and shower facilities. There was a room with sensory and gym equipment, two large activity areas, an enclosed courtyard and a kitchen.

The service is required to have 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. On the days of the inspection the registered manager was on annual leave and the assistant manager was managing the service.

The last full inspection took place on 4 and 8 July 2013; the registered provider was compliant in all areas assessed.

We undertook this current unannounced inspection on 24 and 26 August 2015.

We found people who used the service were protected from the risk of harm and abuse because staff had received safeguarding training and they knew what to do should they have any concerns. Risk assessments were completed for areas that impacted on people’s lives and posed a risk for them.

We found staff were recruited safely and in sufficient numbers to meet the needs of people who used the service.

Staff received training that enabled them to support people safely and to meet their assessed needs. We found staff received guidance, support, supervision and appraisal. This helped them to be confident when supporting people who used the service.

People who used the service received person-centred care based on their wishes and preferences. They and their relatives were involved in the formulation of plans of care. Staff were aware of people’s health care needs and the support they provided helped to maintain them. Staff liaised with health professionals for advice and guidance when required.

We observed positive interactions between staff and people who used the service. We saw people were treated with respect and their dignity was maintained. Staff were overheard speaking with people in a kind, attentive and caring way.

We observed staff supported people to take medicines as prescribed. Staff had received training in medicines management.

We found staff supported people to maintain their nutritional needs. The assisted people to make choices about their meals in line with their care plans.

We found people were supported to make their own decisions and to contribute to their planned activities. When people were assessed as lacking the capacity to make their own choices, decisions were made in their best interest but, how the assessments and decisions were recorded could be improved. We have made a recommendation about this.

We found the registered manager and staff team had developed creative ways in ensuring people felt part of their local community. People who used the service accessed a range of activities and occupations within Danny’s Dream club but also in the wider community; these provided them with stimulation and a feeling of inclusion.

We found there was a good organisational structure and a culture aimed at person-centred care, inclusion, involvement and valuing people who used the service and the staff who worked for the service.

We found the service was well-managed. There was a quality monitoring system that ensured people’s views were listened to, any complaints were addressed, audits were completed and checks carried out on staff practices and performance. There was an ethos of learning to improve practice, and the service provided to people.