The inspection took place on 9 and 10 May 21017 and was announced.

Prime Nursing and Care is a domiciliary care service that provides personal care to people living in their own homes. The service serves the local community around Felsted. They provide a service for adults, who are predominantly older and who may be living with dementia or adults who have a physical or learning disability. At the time of our inspection there were approximately 18 people using the service.

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 had appointed a general manager to assist them in the daily running of the service.

The service had been registered in September 2015. It had been set up by the owner who was also the registered manager and was the driving force behind the service. They were passionate about the care provided and about establishing a service which met the needs of the local community in a family orientated and professional style.

The manager worked alongside staff and so was able to respond promptly to concerns and ensure the service was of a good standard. They had high expectations of the quality of support to be provided and supported staff well to enable them to carry out their role. People, families and staff felt able to speak to the manager about any concerns they had. Professionals were positive about the service.

People were safe at the service. Staff provided care which was not rushed and was focused on people’s safety and wellbeing. Risk was well managed. The manager and staff had taken the necessary measures when they were concerned people were at risk of harm. Staff had been safely recruited and were well supervised in their role. Whilst none of the people required support with administration of medicines, the manager had put systems and measures in place to accommodate this safely, if required.

Staff were well matched to the people they were supporting to ensure they had the necessary skills to meet their needs. Opportunity for formal training had been limited when the service was set up however, however the manager had resolved this and a comprehensive training programme was in place. Staff worked and communicated effectively as a team and had varied opportunities to develop their skills and knowledge.

People made choices about the support they received. The manager had an understanding of their responsibilities under the Mental Capacity Act. People were supported to maintain a balanced diet, in line with their preferences. Staff enabled people to maintain good health and to access health and social care professionals, where necessary.

Rotas were well managed so people were supported by a small staff group. There was a focus on people rather than just the tasks being carried out. Staff had time to get to know people and to develop positive relationships with them and their families. They treated people with respect and dignity. Care was person centred and focused on the outcomes people wanted. Whilst the information in some care plans was limited, staff knew people extremely well and understood what their needs were. When people’s needs changed, the care they received was reviewed and adapted as necessary.