This inspection took place on 8 August 2018 and was announced.

Living Ambitions is a domiciliary care agency. This service provides care and support to people living in their own homes and supports them to live as independently as possible. Living Ambitions provides a service to young and older adults. At the time of the inspection the registered provider was providing support to five people.

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. This was the first inspection since the registered provider had registered with CQC in March 2017.

The registered provider had a variety of different systems and processes in place to assess and monitor the quality and safety of the care people received. This meant that people were receiving safe, effective, compassionate and high-quality care. Such systems included regular care plan and medication audits, care plan reviews, medication competency assessments and quality questionnaires.

Care files contained individual care plans and risk assessments. Information we checked was up to date, relevant and regularly reviewed. Staff were familiar with the individual needs and risks of the people they support. We received positive feedback about the level of safe care people received.

Medication management systems were safely and effectively managed. Each person had robust medication records in place. Records contained the level of support each person required and the level of risk that needed to be monitored. Staff received the relevant medication training and regularly had their competency assessed to ensure they were complying with safe administration policies and processes.

We found that the area of ‘recruitment’ was safely managed. This meant that all staff who were working for the registered provider had sufficient references and disclosure and barring system checks (DBS) in place. DBS checks ensure that staff who are employed are suitable to work within a health and social care setting. This enabled the registered manager to assess level of suitability for working with vulnerable adults.

All accidents and incidents were appropriately recorded and analysed on a monthly basis. The registered manager explained that there was very little activity in relation to accident/incidents but staff were aware of the reporting procedures.

People were protected from avoidable harm and risk of abuse. Staff were familiar wit safeguarding procedures and knew what ‘whistleblowing’ meant. Staff had completed the necessary safeguarding training and there were up to date safeguarding and whistleblowing policies in place.

The registered provider had suitable infection prevention control procedures in place. Staff were provided with the relevant personal protective equipment (PPE) and were encouraged to comply with infection control procedures. There was an infection control policy in place for people to consult if they needed further guidance and support.

We checked if the registered provider was complying with the principles of the Mental Capacity Act, 2005. People’s capacity had been assessed and where appropriate the relevant deprivation of liberty safeguards (DoLS) had been authorised. ‘Consent’ to care had been obtained by people who has the capacity to make decisions and records indicated that people and relatives (where legally able to do so) were involved in relevant decisions which needed to be made.

Staff were supported with training, learning and development opportunities. Staff told us that they were fully supported by the registered provider and had developed the correct skills and competencies to provide the level of support that was