This inspection took place on 14 and 24 March 2017, was completed by one inspector. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in PBS4 provides personal care and support to people in their own homes. At the time of our inspection, the agency was providing a service for five people with a variety of care needs, including people living with a learning disability or who have autism spectrum disorder. The agency was managed from a centrally located office base in Southampton.

There was a registered manager at the service. 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.

The registered manager was committed to ensuring that the service was inclusive and focussed on the needs of the people using the service. The service was governed by an independent board, which had representatives from people who used the service and relatives. This helped the service make sustainable and appropriate choices about how the business grew. The registered manager and enablement director played a prominent role in the day-to-day running of the service. There was a complaints policy in place, the registered manager investigated and relayed findings back to relevant parties in accordance to this policy.

Most people and their families were happy with the communication from the service. Family members told us they were kept informed about important events or incidents when they occurred. People told us the management of the service had stabilised and the level of communication with families had improved.

There were sufficient staff available to meet people’s needs. New staff went through a robust recruitment process, which helped determine their suitability for the role. People and their families told us they were involved in selecting their own staff. The service was in the process of recruiting additional senior staff. Staff received a training programme, which was in line with nationally recognised standards and received additional training to support people’s individual needs.

The registered manager monitored staff performance through support and supervision. Staff performance was measured against their knowledge and application of people’s care plans. This helped the registered manager appraise staff’s performance and set areas for improvement. Staff had received training in safeguarding and understood how to put this training into practice in order to help to keep people safe.

Risks to individuals, including those caused by heightened anxieties were assessed and managed effectively. Where people were involved in incidents, these were analysed to look for triggers and possible ways in which they could be prevented from reoccurring.

People’s care plans were focused on building people’s life skills. People and their relatives helped to develop care plans and were involved when they needed to be updated. People and their families were able to leave feedback for staff, using the service’s computer based daily recording system. This enabled the service to respond to any suggestions or changes required to people’s care plans.

Staff followed legislation designed to protect people’s rights. People were cared for with kindness and compassion by staff that understood the importance of obtaining consent and following legal guidelines where people were unable to consent.

People received their medicines as prescribed and safe systems were in place to manage medicines safely. The service had an emphasis on ensuring that ‘when required’ medicines were taken only when necessary to help ensure people’s safety. Staff had worked with people to manage their anxieties and reduce t