This inspection took place on 23 January 2017 and 30 January 2017 and was announced.

The registered provider, Precious Support Services Limited is a domiciliary care agency which provides support and care to adults with a physical disability or mental health difficulties in their own home. The majority of people receiving a service lived alone, whilst others lived with family members or shared accommodation with live in carers. At the time of our inspection, the agency was providing personal care to 76 people.

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 told us they felt safe and comfortable with the care workers employed to meet their needs. Care workers knew their responsibilities to protect people from the risk of abuse and received training to assist them. People's legal rights were protected and care workers ensured people's right to make decisions were respected. We found people were supported with their medication by care workers who were trained and assessed as competent to give medicines safely and as prescribed.

The provider conducted risk assessments which identified specific risks for each person and gave guidance to care workers about how they could assist people in a way which promoted their independence and choice. Assessments were reviewed regularly so staff had accurate information to refer to.

The provider’s rota system was flexible enough to ensure care workers could safely meet people's needs at the times they agreed. People and their relatives told us they enjoyed the time they spent with their care workers and were confident care workers had the skills and training to undertake the care being provided.

The provider had a clear system for employing new staff and ensured pre-employment checks were conducted prior to staff starting work to confirm workers could be safely employed. Care workers we spoke with confirmed they had not been able to work until relevant employment checks had been completed.

People were able to make choices about the way their care was provided and were supported to do so. Care plans focussed on the individual care and support needs of the person, and copies were stored securely at the main office and where appropriate at people’s homes. Care workers were responsive to people's needs and where people's needs changed they ensured office staff were informed so care plans were adjusted to reflect the change. We found the care plans provided details about people’s preferred methods of communication, favourite activities and personal choices and that these preferences were known to the care workers.

People had access to health professionals when needed and the provider advocated on behalf of people to ensure appropriate health care was provided. People and their relatives knew what to do if they had any concerns about their care, and the provider responded positively to any issues or complaints raised.

The Care workers we spoke with felt senior management were supportive and confirmed they had regular one to one meetings, appraisals and team meetings. Staff had access to training and professional development and a system was in place to ensure training was up to date. Care workers received training on mental capacity and demonstrated an understanding and worked within, the principals of the Mental Capacity Act (2005).

We found the provider had systems to assess, monitor and improve the quality of the service and obtained feedback on the service provided. Care workers were given responsibility and were involved in the day to day running of the service. They felt able to make suggestions about how the service could improve. We also found the views