This announced inspection took place on 14 November 2016. The provider had 48 hours’ notice that an inspection would take place so we could ensure staff would be available to answer any questions we had and provide the information that we needed. Further phone contact was made with people using the services and their relatives on 18 November 2016.

DHC Midlands Ltd is registered to deliver personal care. They provide care to people who live in their own homes within the community. People who used the service may have a range of support needs related to old age and/or dementia, physical disability, sensory impairment, learning disabilities or autistic spectrum disorder or mental health issues. At the time of our inspection 71 people received personal care from the provider.

The service had 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.

People were supported appropriately by staff to maintain their safety and protect them from avoidable harm. Staff received the training required in relation to medicines and periodically had their competency checked in all aspects of care provision. The provider investigated and reported the details of any incidents or accidents as necessary, including notifying the appropriate external agencies. Care staff were aware of the potential; risks to the people they cared for and knew how to support them in order to minimise these. People were supported by regular care staff and were notified of any delays that may occur in them receiving the care they were expecting.

People were supported by competent staff who had the knowledge and skills to assist them effectively with all their needs. New employee’s performance was monitored through meetings and via the feedback management sought from staff supporting them on induction. Staff were able to access the support and any advice they needed both in and out of hours. Staff understood the need to gain people’s consent before assisting them and how to support them to make informed choices. Staff knew clearly how people should be supported with their nutrition and to stay hydrated. When people had specific health care needs staff knew how support them and who to contact if the person became unwell, in and out of hours.

People were supported by caring, supportive care staff. Staff showed a caring nature towards the people they supported and knew people and their needs well. People were satisfied with how they were communicated with and involved in making decisions about their care. People were enabled by staff to remain as independent as possible. Care staff understood the importance of maintaining people’s privacy and dignity when providing care.

People received the care they wanted when they needed it and had their support needs periodically reviewed. Pre assessment information was used to inform the planning of people’s care when they started using the service. People’s cultural and spiritual needs were considered and met. People felt comfortable raising concerns and complaints with the office staff and management. The provider acknowledged, investigated and responded to complaints received in a timely manner and in line with their own policy.

People received a service that they felt made a positive difference to their lives. People and staff were supported through strong leadership from within the service by the registered manager and the management team in general. The provider was transparent in its reporting to us and other external agencies when incidents occurred within the service and there was an effective system in place to monitor the quality of service. The provider encouraged open communication and encouraged staff and people