We carried out this inspection on 19 October 2017. This inspection was announced and the provider was given 48 hours’ notice as the location provides a domiciliary care service and we needed to ensure that the registered manager would be available to support us with the inspection process. This was the provider’s first inspection since the service had registered with the Care Quality Commission (CQC) on 26 May 2016.

DHR Support Service Ltd is a domiciliary care service providing personal care and support to people living in their own homes. At the time of this inspection the service was providing care and support to three people with autism and learning disabilities. The provider’s future plans were to provide care and support within a supported living setting.

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.

One relative told us their relative received safe care and support. A safeguarding vulnerable adults policy was available and accessible by all staff which provided guidance on how to recognise and report abuse. Care staff confirmed that they had received training in safeguarding adults and demonstrated a clear understanding of the different types of abuse and the actions they would take to report any concerns.

Risk assessments in place identified people’s individual risks, the impact on the person and what was needed to reduce or mitigate the likelihood of the risk occurring. Risk assessments were discussed, reviewed and updated by the staff team on a monthly basis.

Care staff supported people with medicines where this was an identified need. For two people receiving support, medicine support was managed in partnership with involved family members. Records confirmed that medicines were managed safely and effectively and were administered by staff who had been trained and assessed as competent to do so.

Records gave assurance that safe recruitment systems were in place to ensure that only care staff suitable to work with vulnerable adults were employed.

Care staff told us and records confirmed that they had all received a comprehensive induction when they first began their employment with the company. Following this they had all received training in a variety of topics as part of an on-going training programme.

Care staff confirmed that they were supported positively through regular supervision and team meetings. Care staff were yet to receive an annual appraisal as they had not completed a full year of employment.

The registered manager and care staff demonstrated a good level of understanding of the Mental Capacity Act 2005 (MCA) and the importance of ensuring people have maximum choice and control of their lives and that they are supported in the least restrictive way possible. Staff also understood the importance of always obtaining people’s consent when supporting them with their care and support. However, although one relative confirmed that they had consented to the care and support that their relative received, care plans had not been signed to confirm that people or their relatives had consented to the care and support that they received.

Care plans were person centred, detailed and reflected the care and support needs of the person. Care plans were reviewed with the involvement of the person, relatives and the staff team on a regular basis and were updated accordingly.

People were supported with their healthcare needs where this support was an assessed need. We saw records detailing visits made to a variety of health care professionals, the reason for the visits, the outcome of the visits and any actions that needed to be taken post visit.

All staff knew the people they care