The inspection took place on 18 October 2018 and was announced, we gave the provider 48 hours notice, this was to ensure staff we needed to speak with were available. This was our first inspection of the service.

Ranger Home Care Ltd offers personal care to people in their own homes by providing a care worker [to be referred to as care staff] who provides ‘live in’ care and support. The service is provided to both younger and older people and those who require end of life care. On the day of the inspection 19 people received the regulated activity of personal care.

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.

There was guidance and procedures in place to protect people from the risks of harm and abuse. There were enough staff to support people safely. The provider had an effective recruitment process to make sure the staff they employed were suitable to work in a care setting.

Risks to people were assessed and action was taken to minimise any avoidable harm. Medicines were managed safely and administered as prescribed and staff had regular competency checks to help ensure they were following best practice.

People were protected from the risk of acquiring an infection during the provision of their personal care. Processes were in place to ensure any incidents were reflected upon and relevant changes made for people's future safety.

People's individual needs had been assessed and from that a care plan was created. Staff were trained to support people with an array of health care needs, in line with recognised best practice. People were supported by staff who had the required skills and training to meet their needs. Where required, staff completed specialist training to meet individual's needs. People were supported to eat and drink sufficient for their needs.

Staff worked both within the service and with external organisations to ensure people received effective care. People were supported by staff to ensure their healthcare needs were met and healthcare professionals' guidance was followed.

The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The service did not currently support any individuals who required assessments under the MCA.

People reported they were treated in a kind and caring manner by staff. People were supported by staff to express their views and to be involved in decisions about their care. People's independence was promoted by staff who encouraged them to do as much for themselves as possible. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights. The registered manager confirmed that should people need information in an alternative way that this would be arranged to meet the accessible information standard.

The service was responsive and involved people in developing their care plans, which were detailed and personalised to ensure their individual preferences were known. People's care plans had information about people's care needs, their wishes regarding independence and any risks identified and how to minimise these. If a person's needs changed then their care plans were updated to reflect this.

Arrangements were in place to obtain the views of people and their relatives and a complaints procedure was available for people and their relatives to use if they had the need.

People were well supported at the end of their life and the service worked with specialist agencies to ensure people could stay in their homes where possible at the end of their lives.

The service was well-led by the registered manager who provided clear and direct