This inspection carried out on the 19 and 25 September 2017 and was announced. This was the first inspection for this provider at this location. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the main office.

Support Solutions provides care and support to people who live in their own homes in York and surrounding areas. The service is registered to provide the regulated activity of personal care to people who misuse drugs and alcohol, children 4-18 years, people with dementia and people with an eating disorder. At the time of our inspection 26 people were receiving the regulated activity of personal care from this provider.

There was a registered manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 registered manager will be referred to as 'manager' throughout the report.

Systems and processes were in place that helped keep people safe from harm and abuse. Care workers had completed safeguarding training and knew the signs of abuse to look out for and how to raise any concerns.

The provider ensured there were sufficient skilled and qualified care workers to meet people's individual needs and preferences. People provided mixed feedback regarding consistent care workers attending their needs. However, the manager confirmed they had no problem recruiting full time care workers to ensure people received the same care workers and did not use agency staff.

People received their medicines as prescribed and safe systems were in place to manage people's medicines. Care workers were trained in medication administration and their competency was checked regularly.

The provider had systems and processes to record and learn from accidents and incidents. These identified trends and helped prevent re-occurrence.

People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People and their relatives were encouraged to participate in the planning of their care and support. Where people did not have capacity to agree to their care records the provider had obtained consent from representatives appointed with Lasting Power of Attorney (LPOA). The manager told us further work was planned to ensure care plans accurately recorded where a LPOA had been validated and the scope of the appointee to make decisions on behalf of the person.

People were supported to eat healthily and any dietary needs were assessed, recorded and responded to.

Care workers had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

People were encouraged to live full lives. The provider held coffee mornings and promoted free transport to encourage people to avoid social isolation.

There was information available, and people were encouraged to raise their concerns and these were responded to.

There were systems of audit in place to check, monitor and improve the quality of the service. Associated outcomes and actions were recorded and these were reviewed for their effectiveness.

The provider worked effectively with external agencies and health and social care professionals to provide consistent care.

Everybody spoke positively about the way the service was managed. Care workers understood their levels of responsibility and knew when to escalate any concerns.

The manager had a clear understanding of their role and responsibilities and requirements in regards to their registration with CQC.