This inspection was announced and took place on 28 February and 1 March 2017. The registered provider was given notice because the location provides a domiciliary care service and we wanted to make sure they were available.

Main Office provides personal care for people in their own homes. At the time of our inspection, there were 33 people receiving personal care from the service. Personal care was provided for people with a range of health conditions often with related physical, mental or learning disabilities.

The registered provider was also the registered manager. 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 very satisfied with the service and the support they received. People had confidence in the staff who supported them. Care staff were familiar to them and knew them well. There were enough staff to provide care and to offer flexibility in the service. The registered manager made sure new staff had a full employment history and obtained recruitment checks before employing them. Staff received training to enable them to deliver effective care. They were supported in their roles by supervision and appraisal.

People received a safe service. We found the service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to provide safe care for people. Risks to people's safety were assessed and reviewed.

Staff understood how consent should be considered in line with the Mental Capacity Act 2005. The registered manager understood the requirements of the law and what action to take if they became concerned about a person's ability to make decisions for themselves.

People were offered choices in the meals and drinks staff prepared for them. Staff understood people's dietary requirements and when necessary left snacks or drinks for the person to have later.

People were involved in planning their care and determining how they wished to receive support. They spoke highly of the care they received and of how staff would assist them with additional tasks if necessary. People's care was reviewed and updated in line with their needs and wishes. Where people could benefit from additional support, referrals were made to other healthcare professionals.

People felt able to contact the registered manager or staff if they had concerns and said they received a quick response.

The registered manager monitored the delivery of care and had a system to monitor and review the quality of the service. Suggestions on improvements to the service were welcomed and feedback encouraged.