Pendennis House is a domiciliary care agency which provides support to people in their own homes. At the time of the inspection they provided care and support 24 hours a day to two people living in their own accommodation in close proximity to the service’s main office in Wadebridge. The service provides specialised 24 hour support including socialisation and inclusion, access to the community or assistance to attend appointments.

This was the first inspection of the service since it registered in October 2016. The inspection was announced. We told the provider three days before our inspection visit that we would be coming. This was because we wanted to make sure people would be at the service to speak with us.

There was a registered manager in post. 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 employed enough staff to ensure the service was run safely and effectively. The agency only accepted packages of care if the registered manager was satisfied there were enough suitably qualified staff available. Staff rotas were planned in advance and people received a consistent and reliable service from staff who clearly understood and could respond to people’s needs.

Staff were trained in safeguarding and they knew how to keep people safe from avoidable harm. People had individualised risk assessments in place that gave guidance to staff on keeping them safe. There was information about people’s levels of risk and how it might be managed, also routines and personal preferences including some situations which might cause anxiety or stress. The provider had policies and procedures and systems in place for the safe recruitment of new staff. Staff completed a recruitment process to ensure they had the appropriate skills and knowledge to carry out their role.

Care records were person centred and contained specific detailed information to guide staff who were supporting people. The care plans included information about the person in a format which was presented in a meaningful way for people to understand. This included large print and pictorial information. Staff said they knew people’s needs because they had the information about the person available to them and information was shared daily between the registered manager and staff.

People told us and we observed people felt safe and secure when receiving support. People received consistent support from care workers who knew them well. One person said, “I’m doing very well. Yes, get on well (with staff).”

Staff received training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to meet people’s care and support needs. One staff member said, “I think the training is very good. We (staff) had training to meet the needs of a person before they started using the service. It meant we understood what they needed and how to approach them."

Where people did not have the capacity to make certain decisions, or had limited capacity, the service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had a good understanding of the principles of the legislation and training was updated as necessary.

Accidents and incidents were recorded, reviewed and monitored by the registered manager. The registered manager was aware of their responsibility to report certain incidents to external bodies, such as the local authority and CQC as necessary.

Medicines were safely managed and staff followed best practice guidance. Medicines were administered safely, timely and hygienically. Medicine Administration Records (MARs) were used to record any assist