We carried out an announced inspection on the 8 September 2016. This was first inspection of this service.

River Garden Care is a domiciliary care service that provides personal care to people in their own homes. They may have a range of conditions including physical disabilities and people living with dementia. There were 35 people using the service at the time of the inspection.

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 management team at River Garden Care provided excellent leadership and, in particular, the registered manager was a very good role model for staff at the service. She provided clear direction and always sought the views and feedback of people, their relatives and professional involved with the service.

There was a strong emphasis on continually striving to improve and this was reflected in the feedback from a ‘client survey’ undertaken in April 2016. The overall satisfaction rate was 96%. As a result of the survey and to seek ways to further improve communication, a client newsletter was introduced. This was to ensure people were kept updated of the outcome of surveys and any actions planned as a result, as well as other important issues in relation to the organisation. People and their relatives were also encouraged to contribute to the newsletter.

There were regular audits undertaken, including, care records, the recruitment process, staffing levels, training and whether people had been involved in decision making. These were checked in line with the CQC five domains, Safe, Effective, Caring, Responsive and Well-led to ensure a high quality service was being delivered.

The complaints process was included in the information book given to people when they started receiving care. People and their relatives were satisfied with outcomes of the complaints recorded and we saw that concerns and complaints were viewed very much as part of driving further improvements.

The safety of people using the service as well as staff was taken very seriously and procedures were in place to safeguard people from abuse as well as ensuring that risks to people’s safety and wellbeing were identified and addressed.

Care plans were detailed and people and their relatives were involved in their development. Staff had a full understanding of people’s care needs and received training and supervision to ensure they had the skills and knowledge to fulfil their roles. People received consistent support from care workers who knew them well.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to support people who lacked the mental capacity in line with the principles of the act and particularly around decision making. People were asked what they liked to eat, how they wanted to dress and their preferences for care delivery. People’s consent was obtained about decisions regarding how they lived their lives and the care and support provided.

Positive, caring relationships had been developed with people, based on compassion and kindness. The registered manager was motivated and committed to providing person centred care that made a positive difference to the wellbeing of people and their relatives that supported them. This commitment was shared by the staff team and we saw this in their enthusiasm for the way they cared for people and their desire to go the extra mile.

Staff had a good understanding of equality and diversity and understood the need to treat people as individuals. There were equality and diversity policies and procedures in place that included clear explanations of the Equalities Act 2010 to ensure staff understood their respo