This inspection took place on 20 July 2018 and was announced. It was the first inspection of Helping Hands Swindon since the service had been registered with the Care Quality Commission in July 2017. We rated the service outstanding.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. People receiving care and support from the service are older adults. Not everyone using the service receives a regulated activity; the 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 our inspection, 36 people were supported with their personal care needs by the service.

There was a registered manager in post. 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. The registered manager was on annual leave at the time of the inspection.

All the people we contacted said they felt safe because they were supported by staff who knew their needs and were able to support them safely. There was a sufficient number of staff to meet people's needs; people confirmed staffing arrangements met their individual needs. Staff knew about their responsibilities to safeguard people and to report suspected abuse. Risks were identified and appropriate steps were taken to manage them. Robust recruitment procedures were followed to ensure only appropriate staff were recruited to work with vulnerable people. People received their medicines on time and in a safe way.

The management team and staff understood used the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and how these applied to their practice. People were supported by dedicated staff to maintain a well-balanced diet and they were provided with access to health professionals to make sure they were as healthy as possible.

People and their relatives spoke extremely positively about the outstanding care they received and described staff and the provider as extremely kind, caring and friendly. The amount of compliments, both verbal and written, was significant and showed how much people appreciated and recognised the impact of the high quality of care. People emphasized the fact that staff were caring and respectful.

People’s relatives confirmed staff showed a high level of compassion towards their family members. People told us the service was reliable and they were kept up to date with changes. Records were well written and individualised, and people had been involved in preparing them. People's privacy was respected and confidentiality was maintained. People were supported by compassionate and caring staff who followed their preferences.

The service was responsive to supporting people whose needs were complex and tended to change.

Care plans were personalised and centred on people's preferences, views and experiences as well as their care and support needs. People's history, family relationships and religious and cultural needs were taken into account.

People and their relatives were delighted with the kindness and thoughtfulness of staff, which exceeded their expectations of how they would be cared for and supported. People explained how staff went the extra mile for them and assured us they couldn't ask for anything more. People told us the support they received significantly improved their well-being. There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager if they needed to.

The service was responsive to people’s needs and wishes even if the support