Guyatt House Care is registered to provide personal care to people in their own homes. At the time of this inspection there were three people using the service who had a learning disability.

This unannounced inspection took place on 25 January and 20 February 2017.

At the time of the inspection there was a registered manager in place. 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.

Staff had an excellent understanding of how to reduce risks to people whilst still enabling them to lead fulfilling lives. This meant that people had the opportunities to take part in experiences that might not otherwise be available to them. Staff had exceptional skills in recognising when people’s behaviour may mean that they did not feel safe. Staff understood what action they needed to take to support people to reduce risks to them. The recruitment process followed meant that staff were not only checked to ensure that they were safe to work with people but also that they had the right values to work with people using the service. The number of staff working with people reflected what people wanted to do on a daily basis. Staff had the training and competency tests to ensure they administered people’s medication as prescribed.

Staff had training that was based on people’s individual needs so that they could deliver care that was effective. Staff had regular support from the line managers and the registered manager; and they were encouraged to develop their roles. Staff knew how to implement the guidelines of the Mental Capacity Act (MCA) 2005 to ensure people’s rights were upheld. People were supported to access relevant healthcare professionals. People were given the support they required to ensure they had sufficient food and drink.

The service had a strong person centred approach. People's dignity was supported and staff treated people with respect at all times. Staff were exceptional at helping people to express their views. People's communication needs were identified and staff worked hard find effective ways of communicating with people. For some people this involved the innovative exploration of technology, such as social media resources, where people could store recordings about their wishes or decision making.

People received consistent personalised care. Care plans were detailed, regularly reviewed and gave staff all the information they required to meet peoples individual needs. People set goals to work towards and their progress was regularly reviewed. People were supported to go to work and take part in social activities that they enjoyed. A complaints process was in place and the service supported people to raise concerns using a variety of ways.

The registered manager and staff had a strong set of values that placed people at the heart of the service. All staff constantly strived to work towards these values throughout the organisation. They were continually seeking to improve the service through following a structured and detailed quality assurance programme. This meant that any areas of improvement were identified in a timely manner and the appropriate action taken. The registered manager was approachable and empowered people, their relatives and staff to voice their opinions.