Step One Services provides care and support to people with a wide range of needs who live in their own homes in the Newton Abbot area. The services provided include a day centre and enabling service as well as assistance with personal care, domestic work and ‘live-in’ care for those people who require a higher level of care. This inspection looked at the care and support of those people who received assistance with their personal care, as other services provided by Step One Services are not regulated by the Care Quality Commission.

One of the company directors held the role of registered manager and managed the service on a day to day basis. 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.

This inspection took place on 30 September and 04 October 2016 was unannounced. The registered person was given short notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the registered office. The inspection included visits to the office, staff interviews and visits to people in their own homes. At the time of this inspection 45 people were using the service, of which 11 were receiving support with their personal care needs.

People, their relatives, staff and social care professionals told us they had a high level of confidence in the service. They told us it had a caring ethos and was well organised and well led. One person said they were receiving a “first class service” and another said, “no service is better”.

People said they felt safe with the staff when receiving care. They said they had a regular staff team whom they had come to trust and know well. Staff had received training in safeguarding adults and knew how to recognise signs of potential abuse. They understood how to report any concerns in line with the service’s safeguarding policy and said any issues would be dealt with thoroughly.

Risks to people’s health and safety had been assessed and regularly reviewed. These assessments included information about how to minimise the chance of harm occurring to people. Staff were provided with step by step instructions about how to help people safely, and provide care consistently. This promoted people’s confidence. The service supported some people to take their medicines.

Personal care plans provided information about each person’s medicines and why they were prescribed. People told us the staff supported them safely and they received their medicines as prescribed.

People were very positive about the way staff supported them and said staff were kind and compassionate. One person said, “They light me up. Best part of my day when they walk through the door!” The registered manager reviewed staff performance through observation, spot checks and supervisions to ensure they were meeting people’s needs and following the guidance in people’s care plans.

People were supported by small teams consisting of four or five staff members. This helped ensure stability and that people got to know and trust their staff team. Staff told us they enjoyed their job and felt they were effective working together. One member of staff said “As a team we work really well. We communicate easily. If there’s a problem, we can always work it out. We will all always do our absolute best for people”. When we asked staff what they felt the service did well, their comments included, “provide consistent care to people”, “Rotas that are stable”, “Small teams of staff who really get to know people” and, “We don’t have missed calls”. People told us they had never had a missed call, and if the staff were going to be late they always received a phone call to notify them. Staff told us they had no concern

At our previous inspection in October 2013 we identified that care workers had not received appropriate training to ensure they were able to deliver care and treatment safely.

At this inspection we found improvements had been made. Care workers had individual training records that identified their training needs. We saw evidence that all care workers had completed a range of training relevant to their job role. This meant care workers were properly trained to meet people’s identified needs.

During our inspection, we visited the provider's office. We spoke with the registered manager, deputy manager two care workers, and people who used the service.

People responded in a positive way when we asked them about the care they received and their care workers. They said “it’s going very well” and “the staff are very good”. We spoke with care workers who were able to tell us how they met people's care needs.

The service had improved its management of medication by the introduction of medication administration record (MAR) sheets. This meant care workers made a record when medicine was given.

We saw evidence that two care workers had received some training from their previous employer. However, we found that care workers had not received appropriate training and updates to ensure they could carry out their job role effectively. For example, care workers had not completed training in infection control, food hygiene, fire, safeguarding vulnerable adults, medication, and moving and handling.

There were systems in place to monitor the quality of the service provided. People were asked to give their views about the support they received.

We spoke to people who use services during our visit. They told us that they were satisfied with the service they were receiving. People told us that staff were supportive and helpful. People told us that they were appreciative of this. They told us that staff were able to meet their needs and always involved them in what they wanted to achieve. One person told us that they needed to improve their maths and staff were helping in achieving this. They told us that they enjoyed the social activities that were available. People told us that staff had asked how they would like to be supported which was good.

We spoke to staff who told us that they enjoyed their work and felt it was rewarding for them. One staff member told us that they involved people in what they wanted to achieve. They told us that people were involved in various activities which included numeracy and literacy. Staff told us that they involved people in community activity to ensure their social inclusion and integration. Another staff told us that people were given choice and that they had a person centred approach to care. Staff told us that they identified people's needs, with their permission get their consent which they would sign to evidence their involvement. We reviewed ththe provider's management of medicines procedures. They did not have recording book for the administartion of controlled drugs.