This comprehensive inspection took place on 23 April 2018 and was announced. We gave the service short notice of the inspection so that the registered manager would be available to assist us.

The service was last inspected on 17, 18 and 19 January 2017, when we identified a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment. This was because the provider did not have adequate medicine management and administration systems in place. Following the last inspection, we asked the provider to complete an action plan to show us what they would do and by when to improve the key questions of safe and well led to at least good. During this inspection, we found the service was meeting the requirements of the current legislation.

This service is a domiciliary care agency. It provides personal care to 79 people living in their own homes. It provides a service for people living with a dementia, learning disabilities or autistic spectrum disorder, mental health, older people, people who misuse drugs and alcohol, physical disability, sensory impairment, younger adults, older people and children.

The service had a registered manager in post at the time of our inspection. 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.

Improvements had been noted in the safe management of medicines. Medications administration records had been updated to ensure a clear record of medicines administration was kept.

Staff understood the procedure to take if they suspected abuse. Training records confirmed staff had undertaken safeguarding training. Individual and environmental risk assessments had been completed. These advised staff about people’s risks and the measures to take to keep people safe.

Safe recruitment procedures were in place that ensured only staff who were suitable for their role were employed by the service. Training records confirmed staff had received the relevant training to support the effective delivery of care to people who used the service.

Information relating to mental capacity assessments and best interests decisions had been recorded in people’s care files. 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 in the service supported this practice.

Records had information about people’s health care needs and people told us that staff sought medical attention when it was required. People and relatives told us they were happy with the care they received and that they were treated with dignity and respect. Care files contained information about how to support people to be independent as well as reflecting their likes, choices and needs.

Care files were detailed, comprehensive, and reflected people’s individual care needs. Where people required support at the end of their life care files had been completed with information about how to support them responsively.

There was good use of technology to support and enable people’s needs to be met.

An effective system to deal with, investigate and act on complaints was seen. We saw very positive feedback about the service.

We received very positive feedback about the registered manager and the changes they had made since commencing their role. It was clear that she was knowledgeable and had an understanding of the operation and oversight of the service.

Feedback and surveys were undertaken that demonstrated the views of people about the care they received. We saw regular team meetings were taking place. This ensured staff had access to information and updates about the service.

Regular audits and monitoring was t