People told us they felt safe and were confident in the staff that provided their care and supported them.

People were safe because staff understood their role and responsibilities to keep them safe from harm.

Staff had a good knowledge of the provider's whistleblowing policy and procedures which meant they were able to raise concerns to protect people from unsafe care.

Recruitment processes were robust and ensured people were cared for by suitable staff. There were sufficient numbers of staff deployed to meet people's needs.

People were supported by staff who received regular training, support and supervision to help them provide effective care.

Staff understood the requirements of the Mental Capacity Act 2005 and their responsibilities to ensure that people who were unable to make their own decisions about their care and support were protected.

People had good relationships with the staff and were treated with dignity and respect.

There were systems in place to monitor the care provided and people's views and opinions were sought regularly.

There was an effective complaints system in place. People told us they were confident to raise any issues about their care and that they would be listened to and addressed.

Staff told us the service was well-led and managed by an effective and organised management team.

People had confidence in the provider and staff were clear about their roles and responsibilities.

Our inspection of 9 October 2012 found that the provider carried out an initial assessment of people’s needs, however, people’s needs had not always been reviewed or reassessed.

At this inspection we looked at the care and support plans of seven people who received support from the service. All the support plans we looked at showed that a review of the person’s care and support needs had taken place recently. The review of support and the reassessment of people’s needs were clearly documented within their care and support plan. One person told us: “I’ve had an OT (occupational therapy) assessment and I’ve been to the opticians everybody is trying to help me.”

Support staff (known to people who use this service as personal assistants) kept a record of how the person’s support time was used. This reflected the support needs which had been identified in people's needs assessment and review. One person said: “There is always somebody there to help me if I need them."

On the day of our visit we were able to talk to four people who use the service. We were also able to talk to four members of staff who provide care and support. Support staff working for this service are referred to as personal assistants. This title is respected within this report.

People we spoke with told us they were very involved in planning the support they needed. Everybody said the personal assistants were always polite and were easy to get on with. One person told us "the staff always knock on my flat door and ask what I need. It’s great to have help to cook and suggest what shopping to get.”

Personal assistants demonstrated a good understanding of people’s needs and how they should be met. Staff knew all the people they supported well. However we found that some people's support plans had not been reviewed. Risk assessments were not always in place to protect people who use the service.

Personal assistants all demonstrated a good knowledge of safeguarding vulnerable adults and were able to describe the steps they would take if they recognised any signs of abuse.

During our visit we looked at five staff files. These all showed that checks had taken place. Safeguards included photographic identification, references, Criminal Records Bureau (CRB) checks and employment history.

People told us that as they see the registered manager regularly they would be quite happy to raise any issues about the service directly with him.

At the time of our visit Enham Care and Support at Home supported a total of 28 people in their own homes. Fourteen people received personal care which is an activity regulated by the Care Quality Commission (CQC). Care workers at this service were known as personal assistants this title has been respected within this report.

Staff we spoke with demonstrated their knowledge of the care and support plans and people’s individual needs. This included their social, emotional and health related needs. People told us that the service was flexible and able to provide support at times that met their needs. One person told us: “[the manager] sends me a list, but I change it”. This was in relation to the personal assistants due to make the calls and the times of their visits.

We saw that support plans were signed by people who used the service to show that they agreed with the support that was planned. However staff understood that people could withdraw their consent at any time.

There was a programme of training in place and this was monitored closely to ensure staff did not fall behind with their training updates. We saw from training records that staff were up to date with the training that the provider had identified as essential for their role.

Incident reports formed part of the analysis by the provider’s director of quality and governance. They reviewed all risk assessments and incidents to decide if further action was needed and if trends could be identified.