This inspection took place on 10 October 2016 and was announced. The provider was given 48 hour notice because the location provides a domiciliary care service we needed to be sure that someone would be in the office.

St John’s Hospital Bath provides care and support to people living independently in their own flats. On the day of our inspection support was being provided to 11 people.

At the last inspection of the service in 3 March 2014 we found the service was meeting the regulations.

The service had a registered manager in place. 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 and associated Regulations about how the service is run.

People told us they were happy with the care that was provided and that it met their needs. They told us staff treated them with kindness and respect. Where appropriate people were supported to have an adequate diet and have sufficient to eat and drink.

People’s care plans were reviewed quarterly and more frequently if changes were required. Risks to people from receiving care were addressed as part of their care planning.

There were sufficient staff to provide care which met people’s needs. Recruitment procedures were followed to ensure only people suitable to work with vulnerable people were employed.

Medication was administered safely and as prescribed. Medication audits were carried out and where discrepancies or omissions were identified action was taken to address the cause.

Staff were provided with regular training, supervision and appraisals. This meant that they had been provided with the skills required to meet people's needs. The manager met staff regularly to discuss their work performance and plan their training and development needs.

Staff were supported by the registered manager. They described an open, friendly, caring culture where they were able to raise any issues or concerns that they had.

The management team monitored quality and safety of the service regularly and action was taken to address any deficiencies that were found and to improve the service.

We spoke with four people, three in their own homes to find out their views of the agency and the service being provided. We also spoke with two care workers and office staff.

People were pleased with the service they received, comments made included “it’s marvellous here” and “I’ve always been happy here”.

The care records showed that people's health needs had been assessed. The records included information from health and social care professionals which helped ensure people got the care and treatment they needed.

People planned the care they received and the agency worked with them so that a package of support was put in place in the way they wanted it to be.

The agency trained their care workers and had procedures which protected people from any form of abuse. People told us they did not have any complaints but would speak to the registered manager or staff if they had any concerns. One person said “I would talk to the manager”. People we spoke with felt safe with the care workers who visited their home. One person said “staff are so good.”

People were protected from the risks of unsuitable care workers because the agency had recruitment procedures that ensured they employed suitable care workers to provide care and support.

The service and the building were monitored and risk assessed to ensure they were suitable for the people using them.

The agency provided a safe service which promoted the wellbeing of people using the service.

People who spoke with us were able to discuss their life at the service and what they enjoyed about living there.

People said they appreciated having their own flats, and being able to choose how they were decorated. One person told us "I've tried to make it nice. It's a big flat so I can get around easier. It’s nice and quiet here”.

People told us they liked living at the service. All the people we spoke with told us they were happy with their decision to live at the service. One person told us "I wasn't very happy so I wrote to them and it was one of the best things I ever did".

Two people who used the service told us they felt safe at the home and that staff were "nice".

Following the inspection we discussed with the provider the details of their registration with us. We agreed they may wish to make some changes to this registration.