The inspection took place on the 12 December 2017 and was announced. The provider was given 48 hours’ notice because the location provides a care at home service. We wanted to be sure that someone would be in to speak with us.

Heath Lodge Care Services Limited is a domiciliary care agency. It provides personal care and support to people living in their own houses and flats in the community. It provides a service to older people. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of the inspection 78 people were using the service.

The service had a registered manager. 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. People were safe because a safety culture was embedded at the service.

There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. The registered manager made sure there was enough staff at all times to meet people’s needs. When the provider employed new staff at the service they followed safe recruitment practices.

There were processes for recording accidents and incidents. We saw that appropriate action was taken in response to incidents to maintain the safety of people. People were protected by the prevention of infection control. Staff had good knowledge in this area and attended regular update training.

People and relatives told us staff were caring and kind and they felt safe using the service. One person told us “My morning carer is brilliant, I know I can rely on them 100% and that makes me feel safe. They treat me with respect”. The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it.

The service considered people’s capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

People’s needs were assessed and regularly reviewed and they received support based upon their needs and preferences. We found the care plans to be person centred and details recorded were consistent.

Staff told us they received training and supervision and were confident in meeting people’s needs. Staff were happy with the level of support they received and told us that communication from management was good. One member of staff told us “It was an effective induction. A weeks training and two days of shadowing. We have regular updates and I have signed up to do a level three diploma in health and social care”.

The registered manager welcomed and encouraged feedback and used this to drive improvement and change. There were quality assurance processes in place to enable the provider and registered manager to have oversight of the service and to ensure that people were receiving the quality of service they had a right to expect. People felt able to make a complaint and were confident that complaints would be listened to and acted on.

People, relatives and staff all told us that they were happy with the service provided and the way it was managed and found management good. One person told us “The manager is particularly helpful but the office staff are also very good and will ring from time to time to check whether everything i