The inspection took place on 02 and 03 November 2016 and was announced. We gave the provider 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office.

Sisterly Care Limited is registered to provide personal care and support to people in their own homes. At the time of the inspection, the service was providing support to 71 people.

A registered manager was 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.

Care plans did not always contain person-centred information. They failed to demonstrate the specific needs, preferences and wishes of each individual person and did not always provide staff with guidance about how to fully meet people's needs. This was an area requiring improvement.

People spoke highly of the service. They told us that they enjoyed good relationships with the staff who visited them and that they would recommend the service. When we visited people in their homes, we observed that they enjoyed warm and friendly relationships with staff.

People told us they felt safe and were protected from harm. Staff were trained to recognise the signs of potential abuse and knew what action to take. People's risks were identified, assessed and managed appropriately. There were sufficient numbers of staff available to support people safely and staff were available 24 hours a day. A robust recruitment system was in place to ensure new staff had all the necessary checks completed before they were allowed to commence employment. Medicines were managed safely by trained staff.

Staff received all essential training to support people's needs effectively. New staff completed the Care Certificate, a universally recognised qualification. Staff were encouraged to pursue additional qualifications by the provider. Staff had at least three supervision meetings a year and attended team meetings.

The registered manager also carried out regular spot checks to monitor staff performance, check on time keeping and to offer support.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and their responsibilities under this legislation.

People had sufficient to eat and drink and had access to a range of healthcare professionals and services.

People were supported by kind and caring staff who knew them extremely well. People spoke highly of the staff who looked after them and said they were treated with dignity and respect. People were involved in all aspects of their care and were supported to express their views.

Complaints were investigated and managed appropriately in line with the provider's policy.

The registered manager monitored the quality of the service and used feedback from people and staff to identify improvements and act on them.

There was a culture of openness and transparency at the service. Staff were positive about the management and leadership of the service. The service had quality assurance systems in place, which were used to good effect and to continuously improve on the quality of the care provided.

We spoke with ten people or their relatives as part of this inspection. We spoke with them about their experiences of the support they had received from the agency. Every one of the people spoken with told us that their care was personalised to their needs and that their privacy, dignity and independence was respected. For example, one person said, "I really look forward to them coming. They are so kind to me when they help me have a bath. I would not change them for the world". A relative told us, "Since this agency has been visiting our mother we have had peace of mind. Mother has a mind of her own, sometimes she accepts help and other times she declines it. The care workers understand and respect my mother's wishes. They give encouragement and support her".

People also felt that staff were well trained to understand their needs. We also spoke with four care workers. They expressed the view that they were supported by management to undertake their roles and responsibilities.

Everyone that we spoke with said that they felt confident that issues would be resolved if raised with management of the agency.

The evidence we gained during this inspection supported the comments made by people and their relatives.