This comprehensive inspection took place on 12 and 13 July 2017 and was announced. Millrose Care is a small domiciliary care agency situated in Bideford. It was registered with the Care Quality Commission (CQC) in 2016 and this was its first inspection.

The service provides personal care and support to older people in their own homes. The service currently covers the Bideford area only.

At the time of our inspection, the service provided a service to approximately 14 people. The times of people’s visits ranged from 15 minutes up to one hour. The frequency of visits ranged from one visit per week to 28 visits per week dependent upon people’s individual needs. The service employed 8 care workers who worked both full and part-time.

The service had two joint registered managers who were present during the inspection. A registered manager is a person who has registered with the 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.

The service cared for people, relatives and their pets keeping them at the heart of the service. There was a strong emphasis on compassion, kindness, caring and respect. Feedback from people and relatives was very complimentary. They all expressed satisfaction with the management of the service, knew the registered managers well and spoke highly of the care workers. People valued their relationship with staff and felt staff often went ‘the extra mile’ for them. One care worker said, “When have I gone the extra mile? Little things like cutting flowers from a client’s garden so they can enjoy them nearby or reading aloud some poetry to a client who was feeling despondent to raise their spirits … I hope I always pay attention and deliver person centred care, I certainly try to.”

People were supported to express their views and were involved in decision making about their care. Care records recorded life histories about each person, their life and what mattered to them. Families and other relatives were also supported by the service. One relative said, “There is a family feel about this service … they always do little things for me and care about me too.”

People benefitted from care workers who were safely recruited, trained and supported to do their jobs properly. They felt the care was very good and there were never any missed visits. People felt their needs and wishes were the focus of the service and the care workers who supported them. They received consistent care from a team of care workers who knew them well and also cared for their family members. Meaningful and strong relationships had developed over time. People’s comments included, “I am really happy with this service … I look forward to them (care workers) coming in” and “They are lovely, all nice”. A relative said, “There is a family feel about this service … they always do little things for me and care about me too.” One person had even written a poem about the service to show their gratitude of the care delivered; they referred to the care workers as “ministering angels”.

Care and support was planned and focussed on people’s individual needs, choices and preferences. The service responded positively and quickly to any changes in people’s conditions. People and relatives gave us examples of how the service had responded to meet people’s individual needs. People’s independence was promoted and people were encouraged to help themselves as much as possible. People were assisted to eat and drink meals of their choice. Medicines were given in a safe way by staff who had been trained in this area.

The safety of the service was taken seriously and the providers and care workers were aware of their responsibility to protect people’s health and well-being. There were systems in place to ensure any identified risks were managed and reduced as