This inspection took place between 1 and 10 November 2017 and was announced. This service is a domiciliary care agency. It is registered to provide personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults, people living with dementia, and people with a physical disability or sensory impairments.

At the time of our inspection there were 10 people using the service who lived in Milton Keynes and Bedfordshire areas. Their head office is located in Bedford.

This announced comprehensive inspection was undertaken by one inspector. This is the first inspection of this service since it was registered.

A registered manager was in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff knew, as a result of the training, what keeping people safe meant. This was as well as how to report concerns and the organisations they could contact should they suspect or identify any risk to people’s safety.

The registered manager had policies and procedures in place to respond to any accidents and incidents such medicines administration errors. These procedures were effective in driving improvements to help prevent any recurrences. A robust recruitment process helped ensure that only staff who were deemed suitable due to their skills and suitable character were employed to work with people using the service.

Staff whose competence had been assessed to administer people’s medicines did this in a safe way. Medicines were managed in line with current guidance.

Risks to people were assessed and managed safely including those identified within the person’s home environment and whilst out in the community. Checks on equipment used by staff, such as that for moving and handling, were undertaken to make sure that it was safe to use.

People's needs were met by a sufficient number of competent staff who had the right skills to provide people with support when they needed it.

Staff were provided with training, support and mentoring that was appropriate to their role. This helped them to provide care that met people’s needs in a person centred way.

People were effectively supported with their eating and drinking needs. They were also enabled by staff to access health care services and support such as those from a community nurse.

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.

People were well looked after and cared for by staff who considered people’s equality and any diverse needs. People could be as independent as they wanted, or needed to be as well as being given privacy and treated by staff who respected their rights.

People were given a range of ways in which they could comment about the quality of their care. This included day to day contact with staff and frequent visits from staff with a management role. Any comments/concerns were acted upon swiftly and to the person’s satisfaction.

People's care needs, including assistance with pastimes and interests were responded to by staff in a person centred way. This meant that staff promoted and supported people to lead a more meaningful life. People’s end of life care was promoted in line with the latest guidance and as a result people, when possible, could spend their last days with the people and surroundings that mattered.

The registered manager had created an inclusive atmosphere within the service and this had fostered an open and honest staff team culture. Staff were supported in a positive and learning environment where any poor ca