This inspection took place on the 30 March 2017 with an announced visit to the agency office. In addition we carried out telephone interviews with people using the service on the 30 and 31 March 2017 and telephone interviews with staff on the12 May 2017. Serve provides personal care to people living within their own homes in the community. At the time of the inspection 107 people were using the service.

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 a positive approach towards supporting people’s independence and their rights to take risks within their capabilities. Staff were knowledgeable about safeguarding and how to protect people from the risks of abuse. Accidents and incidents were closely monitored and actions were taken to mitigate anticipated accidents.

Safe recruitment practices were followed and sufficient numbers of skilled staff were available to meet people's needs by a core staff team. This fostered trusting relationships between people using the service, their relatives and staff. People received their medicines safely, in keeping with best practice guidelines.

Staff received training on the Mental Capacity Act (MCA) 2005 including the Deprivation of Liberty Safeguards (DoLS). They put their learning into practice by involving people in making decisions about their care. There was a strong, person centred culture, which supported people to exercise choice and express their views.

Staff had the knowledge and skills required to meet people's individual needs and promote their health and wellbeing. The staff had regular supervision and annual appraisals from their managers. Systems were in place to continually assess their skills and where gaps were identified further training and support was provided. Staff felt valued, included and good practice was celebrated.

People were supported to eat and drink sufficient amounts to meet their nutritional needs, dietary preferences, likes and dislikes. The staff worked in partnership with other health care professionals to support people to access health services quickly.

Staff were motivated and inspired to offer care that was kind and compassionate. They enabled people to remain independent and ensured their privacy and dignity was always respected.

The care plans were written with the involvement of people and / or their representatives. The views of people were regularly sought and acted upon to continuously improve the service.

Information on how to raise any concerns or complaints was available to people and concerns and complaints were used as opportunities to reflect on the service to develop and learn.

People, relatives and staff were very positive about the leadership of the service and the support they received from the service. The ethos and vision put people at the heart of the service.

Established management systems were in place to continually monitor the quality of the service and support the staff. The service strived for excellence through regular consultation with people using reflective practice.