The inspection took place on 10, 12, and 16 May 2017 and was announced.

Suite 13, Clear Thinking Care Limited provides home care support to adults within Plymouth and the surrounding area. They support people living with a learning disability, a mental health condition, a physical disability, substance misuse, dementia and sensory impairments.

On the days of our inspection the service provider was providing personal care to four people.

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 told us they felt safe when staff entered their homes. Staff understood what action to take if they were concerned someone was being abused, mistreated or neglected.

People were protected from risks associated with their care because staff knew people well and could describe what action they would take in order to keep people safe, however risk assessments were not always in place. This meant staff did not always have the necessary information written down; to ensure the continuity of people’s care and to help mitigate ongoing associated risks. Following our inspection the registered manager had taken immediate action to update people’s care plans to ensure risk assessments were in place.

People’s environment had been assessed for risks and people were protected in the event of a fire because they had been supported to obtain the necessary fire equipment for their home. People were supported by staff who had received training to help prevent the spread of infection.

People told us there were enough staff to meet their needs. The registered manager involved people and their families in the recruitment process. Staff were recruited safely to ensure they were suitable to work with vulnerable people. The provider had disciplinary procedures which were used when staffs’ conduct had been unsatisfactory.

People, who required support with their medicines, were supported by staff who had received training. The provider had a policy and procedure in place to help ensure medicines were managed safely.

People told us they felt the staff had the skills and experience to meet their needs. Staff were complimentary about the training and support they received. New staff joining the organisation received an induction and the registered manager implemented the Care Certificate when necessary. The Care Certificate is a set of standards that social care and health workers are expected to work to. It is the new minimum standards that should be covered as part of induction training of new care workers.

People's human rights were protected because the registered manager and staff understood their responsibilities in relation to the Mental Capacity Act (2005) and people's care plans recorded their mental capacity so staff were aware of how to individually support each person.

People were supported and encouraged, when required, to eat and drink throughout the day. People's care plans, provided guidance and direction for staff about how to meet people's nutritional and hydration needs.

People were supported to access health care services, such as their GP or district nurse. Some people had a ‘hospital passport’ in place. A hospital passport is a document which assists people with learning disabilities to provide hospital staff with important information about them and their health when they are admitted to hospital.

People told us staff were kind and caring. Staff knew people well and spoke fondly of them. Staff, were able to tell us about people’s likes and dislikes and how they enjoyed spending their day. However, although staff knew people well, people did not always have care plans in place to provide guidance and direction