We inspected Swanborough Services on the 17 January 2017. We previously carried out a comprehensive inspected at Swanborough Services on 18 September 2015. We found the provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because we identified concerns in respect to people not receiving planned person cent red care, people’s consent to care and treatment not being sought, the assessment and management of risk not being robust, quality monitoring, a negative culture where staff were not supported and inadequate staffing levels. The service received and overall rating of ‘requires improvement’ from the comprehensive inspection on 18 September 2015. After this inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to these breaches. We undertook this announced comprehensive inspection to look at all aspects of the service and to check that the provider had followed their action plan, and confirm that the service now met legal requirements. We found that improvements had been made and the overall rating for this service has been revised to good.

Swanborough Services is a domiciliary care agency providing personal care for a range of people living in supported living environments in the Brighton and area. People using the service may have neuro-disabilities or an acquired brain injury (ABI).

The inspection took place on the 17 January 2017 and was announced. The provider was given 72 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

The service had a registered manager. 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 service had changed significantly since the last inspection and was no longer providing a service to the general community. The service had moved office locations from Burgess Hill, West Sussex, to Tonbridge, Kent, and now only provided care to people living in supported living flats and houses. At the time of our inspection, the service was supporting 10 people and employed approximately 10 members of staff.

At the last inspection, we found the provider’s audits were not taking place and that systems to gain feedback, recognise issues and drive improvement had not been implemented. Improvements had been made and systems were in place to identify, assess and manage risks to the health, safety and welfare of people.

People told us that staff were friendly and caring. A relative said, “The care is outstanding”. People were happy with the care they received, and said they saw regular consistent staff that knew them well and treated them with kindness. One person told us, “I get two [care staff] in the main. Very good”.

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. People were supported to maintain good health and had assistance to access to health care services when needed.

Risks to people were assessed and monitored to ensure action was taken to avoid accidents and the deterioration of people’s health. The service had recruited a sufficient number of suitably qualified staff to meet people’s needs. Recruitment practice was robust and protected people from the risk of receiving support from staff who were unsuitable.

The service considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded.

Staff were