This inspection took place on 26 and 31st October 2017 and was announced. We told the provider one day before our visit that we would be coming. This is the first inspection for this service which was registered in November 2016.

Miracle Agency Limited provides domiciliary care and support to three people living in the Hertfordshire area. This service includes assistance with all personal care, meal preparation, eating, medicines administration and general domestic chores. We only looked at the service for people receiving personal care during this inspection as this is the service that is regulated by CQC.

The service had a registered manager. 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 provider had only been delivering services to people for the past four months, but during that time had established good practices and procedures which would help as the service expanded.

People were safe in their homes. Staff could explain to us how to keep people safe from abuse and neglect. People had suitable risk assessments in place. The provider managed risks associated with people’s homes, to help keep people and staff safe. Recruitment practices were safe. Staff were trained in medicine administration and prompted people to take their medicines safely, although families actually administered the medicines from blister packs.

People were supported by staff who received appropriate training and support. Staff had the skills, experience and a good understanding of how to meet people’s needs. Staff were providing support in line with the Mental Capacity Act 2005. When required people were supported to eat and drink sufficient amounts to meet their needs. Staff worked well with the people’s GP and the district nurses, to ensure they stayed well and comfortable.

People and relatives told us staff were caring, kind and efficient and staff respected their privacy and treated them with dignity.

People’s needs were assessed before they started to use the service and care was planned and delivered in response to their needs. The provider had arrangements in place to respond appropriately to people’s concerns and complaints.

Systems were in place to monitor and improve the quality of the service. The provider had effective quality assurance systems to monitor the scheme’s processes. These systems helped ensure people received the care they needed as detailed in their support plans.