We carried out this inspection on 5 and 6 March 2018 and it was announced 48 hours in advance in accordance with the Care Quality Commission's current procedures for inspecting domiciliary care services. This was the first inspection for the service under this registration.

STEPs Mid (Short Term Enablement and Planning Service) is a domiciliary care service registered to provide personal care and support to adults, of all ages, in their own homes. These may include older people, people with physical disabilities, people with sensory loss including dual sensory impairment, people with mental health problems, people with learning disabilities, people with dementia and people in need of palliative care support. Care packages are for a period of up to six weeks. The aim of the service is to re-enable people to maximise and regain their independence at home, after a period of illness and/or hospital stay.

At the time of our inspection 48 people were receiving a personal care service. The services were funded either privately or through Cornwall Council or NHS funding. Referrals for packages of care were made to the service by health and social care professionals. These included hospital discharge teams, physiotherapists and occupational therapists.

There was a registered manager 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.

The workforce was made up of a registered manager, nine team leaders, approximately 35 STEPS care workers and an office support worker.

There was a positive culture in the service, the management team provided leadership and led by example. Staff described the service as “Very strong”, ”It provides a good service to people; it’s well run” and “A good company to work for. We do the best with the resources we have.”

People told us they were happy with the service they had received. Comments included, “I am very grateful to them. I would not be where I am today without their help” and “I cannot praise the ladies enough for their assistance. I thought it was wonderful; kind and cheerful.”

People said staff were kind, caring and compassionate while also being respectful of people’s privacy and dignity. Comments included, “They gave me personal care and were very careful to maintain my dignity when they were bathing me”, “They are very careful to maintain my dignity” and “All the carers were very respectful.”

People confirmed they were supported by a team of regular, reliable staff; they knew the times of their visits and were kept informed of any changes. No-one reported experiencing missed visits. People told us staff were patient, did not rush them and provided care and support at their pace. The focus was on enabling people to do as much as possible for themselves. People told us, “They were amazing I can’t speak highly enough of them, they deserve it. I got better because of their help” and “They are brilliant I can’t fault them” and “Lovely girls. Never rush me and always time for a chat.”

Staff were knowledgeable about the people they cared for and responded appropriately as people's needs changed. Staff spoke positively about the people they supported and were motivated to provide an individualised service in line with people's needs and goals. Comments from staff included, "I have worked for the service for a long time and I love my job. I get a lot of job satisfaction from helping people to regain their independence and feel stronger.”

People were involved in decisions about their care and staff encouraged and empowered them to achieve their goals. Care plans provided staff with clear direction and guidance about how to meet people’s individual re-enablement needs and goals. Care plans were reviewed we