The inspection took place on the 21 November 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.

Ideal complex care provides a care at home service for adults and children. It provides personal care and support to people and their relatives living in their own homes, which included people with complex nursing needs. At the time of our inspection seventeen people were receiving a 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.

People and relatives told us staff were caring and kind and they felt safe using the service. “I am very happy and have confidence in the staff, they keep my relative safe who is totally dependent and needs constant interventions, care and vigilance throughout the night”. One person told us “My carers are all really lovely, they treat me with respect and dignity, they always ask before they do anything and I find them very helpful and friendly”.

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.

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 and their relatives that they were happy for them to undertake care tasks before they proceeded.

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 “We get loads of training and updates. We have a detailed induction, shadow experienced staff and can ask for extra training to ensure we meet everyone’s needs”.

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

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, relatives and staff all told us that they were happy with the service provided and the way it was managed and found management caring and approachable. One relative told us ““It is a very professional organisation, they show deep care and respect and want to 'get it right’, they are flexible and completely trustworthy”. A member staff told us “It’s a great place to work, I love my job, the management are very supportive and always on hand, I’ve worked with a few agencies and this is by far the most professional and well run”