This announced inspection took place on 10, 11 and 18 April 2017. Right at Home provides a domiciliary care service to enable people living in Basingstoke and the surrounding areas to maintain their independence at home. At the time of our inspection there were 21 people using the service, who had a range of health and social care needs. All of the people who were supported by the service had commissioned their care privately. Some people were being supported to live with dementia, whilst others were supported with specific health conditions and mental health diagnoses. At the time of the inspection the provider deployed 15 staff to care for people and meet their individual needs.

The service had a registered manager who was appointed in October 2016. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 provider operated a franchise system where individual branches were owned and operated by nominated individuals. The provider operated a robust selection process for prospective owners and provided comprehensive training prior to the service opening.

People were supported by staff who made them feel safe. People and relatives told us the continuity and consistency of staff was very good, which reassured them and lessened their anxiety. People were kept safe and protected from abuse because staff understood their role and responsibility in relation to safeguarding procedures.

The registered manager completed needs and risk assessments, which promoted people’s independence, while keeping them safe. Risks associated with people’s care and support needs were identified and managed safely to protect them from harm. Staff provided people’s care safely in accordance with the guidance contained within their care plans.

The care coordinator completed a weekly staffing analysis to ensure there were sufficient staff available to meet people’s needs. Rosters demonstrated that the required number of staff to meet people’s needs was always provided.

Staff had undergone relevant pre-employment checks as part of their recruitment, which had been verified by the provider. People were safe as they were cared for by staff whose suitability for their role had been assessed by the provider.

People’s medicines were administered safely, in accordance with the provider’s policy, by trained staff. Staff had received medicines management training and their competency was assessed by the registered manager. Staff felt confident managing medicines because their training had prepared them to do this.

Staff had the necessary skills and knowledge to provide the support required and delivered care in accordance with people’s support plans. People were supported by staff who had completed the provider’s required training and induction programme which enabled them to support people and meet their needs effectively.

Staff were supported by the management team to deliver effective care based on best practice, through an effective system of supervision, spot checks, appraisal and monthly staff meetings. Staff had received regular unannounced spot checks by the registered manager who had observed and assessed the quality of their care practice.

People’s human rights were protected by staff who demonstrated clear understanding of guidance and legislation relating to consent and mental capacity. The registered manager and staff had initiated best interests processes where required to ensure people’s human rights were protected.

People were supported to maintain a healthy balanced diet by staff who understood their dietary preferences and ensured they received sufficient to eat and drink.

Staff were alert to people’s changing needs and took prompt action to promot