This inspection took place on 1, 9, 15, 16 and 17 November 2016 and was announced. The registered provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in to assist us. This was our first inspection of the service.

Mencap - Darlington and Teesside Domiciliary Care Agency is a domiciliary care agency located in Thornaby, in the Tees Valley. It provides personal care to people in their own homes. At the time of our inspection 22 people were receiving personal care. These included younger adults and older people with a range of physical and learning disabilities.

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 and their relatives told us staff kept people safe. Risks to people using the service were assessed and plans put in place to reduce the chances of them occurring. Accidents and incidents were monitored by both the registered manager and a health and safety officer employed by the registered provider.

The service had a business contingency plan in place to assist staff in keeping people safe in emergencies. People’s medicines were managed safely. Procedures were in place to minimise the risk of abuse occurring and staff told us they would be confident to raise any concerns they had, to either the registered manager or the local safeguarding authorities.

The registered manager monitored staffing levels to ensure enough staff were employed to support people safely. The registered provider’s recruitment process reduced the risk of unsuitable staff being employed.

People and their relatives told us staff were effective at meeting their support needs. Staff received mandatory training in a wide range of areas and spoke positively about it. Staff were supported through regular supervisions and appraisals.

Staff worked within the principles of the Mental Capacity Act 2005. Where people received support with food and nutrition their dietary needs and preferences were documented in their care plans. Staff supported people to access other healthcare professionals to maintain and improve their health.

People and their relatives spoke positively about the care they received from staff, describing the service as kind and caring. People and their relatives told us staff treated people with dignity and respect.

Staff told us care plans contained all of the information they needed to offer personalised and caring support, including information on people’s relatives and things that were important to them. People were supported to access advocacy services where these were needed.

The registered manager and staff had an excellent understanding of people’s support needs and preferences. Care plans were written from the perspective of the person they belonged to, and their sense of identity was present throughout. Where a support need was identified staff worked hard to be innovative in providing person-centred care based on best practice.

Some people received support with accessing activities. Where the service was responsible for this staff were innovative and successful in meeting people’s individual needs.

Clear processes were in place for responding to and learning from complaints. People and their relatives said they were confident to raise any issues they had and were sure staff would work to address them.

Staff spoke positively about the culture and values of the service and about the registered manager, describing her as approachable, supportive and inclusive.

The registered manager and care managers carried out quality assurance checks to monitor and improve standards at the service. The service r