The inspection took place on 10 October 2017 and was announced. The provider was given notice because the location provides domiciliary care services and we needed to be sure that someone would be available to answer our questions and assist with the inspection. We contacted people who used the service by telephone on 11 October 2017 and staff on 30 October 2017 to ask their views.

Esk Moors Caring Limited is a non for profit organisation based in Castleton and provides personal care to people in their own homes within Castleton and surrounding areas. The service has close links with Abbeyfields, an extra care housing scheme at Langburn Bank, Castleton, and has an agreement with this organisation to provide personal care and support to those tenants who are assessed to require this.

The service was registered with CQC in November 2016 and this was the first inspection. At the time of inspection, 28 older people used the service, some of which were living with a dementia. The registered manager was present throughout the 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.

Safeguarding procedures and policies were robust and staff demonstrated their understanding of safeguarding procedures to ensure people were protected from any harm. Staff had a clear understanding of their duty to whistle blow should they suspect or witness poor practice.

Risks for people were well managed through individual risk assessments that identified potential issues and provided staff with information to help keep people safe from avoidable harm, while supporting them to maintain their independence.

Procedures were in place to guide staff on the safe administration of medicines and staff had received medicines training. The records we checked showed that people had received their medicines as prescribed.

Robust recruitment procedures were in place. We found that appropriate checks had been completed before new staff commenced employment. Staffing levels were adequate to meet people’s needs and ensure that visits were not missed.

New staff completed a thorough induction program before they began working in the community. People were supported effectively by trained staff who understood their needs. Records showed staff had completed a number of training courses to ensure they had the skills to support people effectively.

Staff had received support through a regular system of supervisions and appraisals. Competency observations had also been completed to monitor staff performance and ensure they were providing safe and effective care and support.

Staff had received training and understood the requirements of The Mental Capacity Act 2005 (MCA) and the provider had a policy and procedure in place.

People consented to care and support from staff by verbally agreeing to it. We found people had been involved in planning their care and had signed their care plans.

People were supported to maintain a healthy and balanced diet. We found that care plans contained details of people’s preferences and any specific dietary needs they had, for example, whether they were diabetic or had any allergies.

Care records contained evidence of close working relationships with other professionals to maintain and promote people’s health.

People using the service told us they were well cared for by staff and spoke positively about the support they received. Staff told us they worked in a way that protected people’s privacy and dignity. Staff respected people’s choice and decisions they made.

Basic information around people’s end of life wishes had been recorded when a person started using the service. More in-depth care plans were developed when appropriate.

Care pla