This inspection took place on 13 February 2017 and was announced. The provider was given 48 hours because the location provides a domiciliary care service; we need to be sure that someone would be available in the office.

Spectrum Continuing Care CIC provides personal care and support to people in their own homes. At the time of this inspection they were providing a personal care service to nine people with a variety of care needs living in the Southampton area.

There was a registered manager at the service. 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.

At the last inspection in December 2015, we asked the provider to take action to make improvements to the quality monitoring procedures and to ensure people's legal rights to make decisions were assured and the Mental Capacity Act 2005 was fully implemented. The registered manager sent us an action plan and at this inspection we found this action has been completed.

People felt safe and staff knew how to identify, prevent and report abuse. Legislation designed to protect people's legal rights was followed correctly. Staff were aware of consent and how this affected the care they provided. People said staff always obtained their consent before providing care. Staff offered people choices and respected their decisions. People were supported and encouraged to be as independent as possible and their dignity was promoted.

The registered manager and provider were aware of key strengths and areas for development of the service. Quality assurance systems were in place using formal audits and through regular contact by the provider and registered manager with people, relatives and staff. People and relatives were able to complain or raise issues on a formal and informal basis with the registered manager and were confident these would be resolved. Plans were in place to deal with foreseeable emergencies and staff had received training to manage such situations safely.

Care plans provided comprehensive information about how people wished to be cared for and staff were aware of people's individual care needs and preferences. Reviews of care involving people were conducted regularly. People had access to healthcare services and medicines were managed safely. People received support to manage their dietary needs if required.

People and their relatives said they were very happy with the service and care they received. They said staff were kind and caring. Staff had built good relationships with the people they provided care for. People and their relatives told us care was provided to them with respect for their dignity by a consistent care staff team. There were enough staff to meet people's needs. The recruitment process helped ensure staff were suitable for their role. Staff received appropriate training and were supported in their work.

We spoke with one person and two relatives of people who used the service. They were all very pleased with the support they received. One person told us, "I have got to know the carers coming in to help me and they are so helpful and friendly." A relative said, "We just don't know how we would have coped without the support from SCIL. The carers are consistent and nothing is too much trouble for them." Another relative said, "We are completely involved in the care plan and have only got to mention something to the carers and the plans are changed."

We found the service carried out a detailed assessment of needs for each person and made sure they understood the type of care and support each person received. The manager told us they matched staff skills with the needs and personality of the person requesting a service. The care plans we saw clearly identified the duties for each visit and gave staff guidance on how to carry out those duties.

We spoke with the manager and staff about their administration of medicines policy and practice. We saw staff received training in the administration of medicines and were observed in their practice.

The manager told us about their recruitment processes and we saw this was recorded in staff records. Appropriate checks were carried out on staff before they worked with people in their own homes.

We saw the service received positive feedback from surveys they carried out to monitor the quality of the service they provided. There were good processes in place to monitor missed calls and complaints. The service demonstrated how they responded to concerns and comments from people who used it.

People told us that the service was provided on a very individual basis and they always felt involved in the care plan. One person said "it was good to have a service that you know will do the best to support you in your own home". Another person said "staff were very helpful and most importantly reliable". A commissioner of the service told us that they used a solution focused approach which was very person centred. A member of staff informed us that they received good support and were trained to do the job well. Another person said "staff make me do things for myself and are there to help me, not to do everything for me."

We found that the service provided a highly individual service with well laid out care plans and ensured there was consistent care to support individuals with a small number of staff that the individual knew.

This inspection took place on 17 and 22 December 2015. The inspection was announced as the service provides domiciliary care and we wanted to make sure that somebody was in the office who we could talk with about the service.

We previously inspected this service on 15 November 2013 where no concerns were identified.

SCIL - Unity 12 provide a range of services to people living in their home in packages of care designed to meet their needs. These included support for people to recruit and manage their own personal assistants. They also provided personal assistants to deliver personal care to individuals. At the time of our visit they were providing care to 13 people who had a range of physical or learning disabilities.

A registered manager was not in place, however the provider had appointed a manager who was undergoing the process of registering with the CQC. 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.

People were not always receiving effective care. Mental Capacity Act assessments were not being completed on behalf of people who lacked capacity to make certain decisions. Staff had not received training on the Mental Capacity Act and it’s application in care settings.

Staff had received supervisions but not regularly. This had been identified and plans were in place to improve the frequency and quality of the supervisions. Staff training was comprehensive and ensured staff had the knowledge and skills to support people.

The provider had not regularly audited the service to assess, monitor and identify where the quality of the service could be improved. This meant that the service had not been regularly checked by the provider to ensure it met current regulations and was fit for purpose.

The provider managed their responsibility to ensure people were safe by training staff in safeguarding and having policies and procedures in place to respond to abuse. Staff knew how to identify and report any signs of abuse. Risks to people whilst receiving personal care had been assessed and steps taken to minimise the risk to people.

There were sufficient numbers of staff to deliver the care people required. Staff were recruited appropriately with checks made of their suitability to work in people’s homes.

Where medicines were required to be administered by staff appropriate systems were used to ensure this was done safely.

Where people required support with nutrition this was included in their package of care. Staff helped people to choose the support they required with preparing and assisting them with their meals. They also assisted people to attend medical appointments and shared communications with visiting healthcare professionals.

People enjoyed positive relationships with staff who worked in their homes. Staff knew the people they supported well and included them in all decisions about their care. People were encouraged to give their opinions of their care and felt that staff and managers listened to them.

Care plans were personalised and highlighted important information, history, likes, dislikes and preferences of people. These were regularly reviewed and people were able to make changes if they wished to. When people’s needs changed these were clearly shown in the care plan.

There was a clear culture within the organisation and service of providing the lifestyle people wished to have. Staff worked with people to maintain skills and independence. People and staff said the service was well managed and the manager was approachable. The manager had some systems in place to monitor the day to day quality of the service.