The announced inspection took place on 11 October 2018 and 12 October 2018. We announced our intention to inspect the domiciliary service so we could be sure the registered manager, staff and people receiving a service were available to talk to us.

Tavy Care Services is a care service registered to provide personal care to people in their own homes (domiciliary care). The service specialises in providing support to people in the local community who live in and around the town of Tavistock. At the time of our inspection 60 people were receiving support from the service. Most people were receiving personal care. Some of these people also received help with cleaning or shopping. This part of the service is not regulated by us and was not part of this inspection. The majority of people received regular short support visits at a time to suit them.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There was 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 2008 and associated Regulations about how the service is run.

We found the Caring domain to be Outstanding. People were always treated with kindness, respect and compassion. The registered manager led a team of staff that were highly motivated to offer care that was exceptionally compassionate and kind to people receiving support and their families.

There was evidence of a strong, person centred culture. People were given every opportunity to express their wishes regarding their care and support and how they were feeling at that particular time. If there was anything the care staff could do to improve the person’s well-being this was done. The registered manager stressed the importance of getting to know the person and understanding what was important to them.

There were many examples of the empathy staff had with people and the action they took as a result. They changed rotas so they could eat their lunch with people who were alone. Staff asked to have calls put at the end of their working day so they could spend extra time with them to share their interests or complete additional tasks.

People received care that was responsive to their needs because all staff involved in the service understood the importance of knowing people well and continually checking that the support they were providing continued to be what the person required.

People told us they felt safe with the staff who supported them. One person told us they had complete confidence in the service. “They are very good. It is a professional service but they keep me cheerful too.”

People received the care they needed to keep them safe in their own homes. They told us about the arrangements in place to enable staff to enter their homes safely and with regard to their privacy and independence.

The provider had systems and processes in place to keep people safe and minimise the risk of abuse. Potential new staff were thoroughly checked to make sure they were suitable to work with people in their own home. New staff were able to shadow experienced staff and did not complete visits to people alone until they felt confident.

People were supported by sufficient numbers of regular staff to meet their needs. People received reliable support from a team they knew. Staff arrived on time and did not let people down.

People were assessed to establish whether they needed or required assistance with medicines. Staff understood the varying levels of assistance that could be offered to people and the importance of clearly recording any medications they prompted or administered to people.

People received effective support from staff who had the skills and knowledge to meet their needs. People and th

The inspection took place on 15 and 17 March 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure somebody would be available at the agency office.

Tavy Care is a domiciliary agency, which opened in November 2014. The agency provides care to people in their own homes in Tavistock and surrounding rural areas. This was the first inspection of the service. There were 26 people using the service at the time of the inspection.

There was a registered manager who is also the registered provider. 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.

People using the service, their family members, staff and health care professionals were very happy with the care and praised the service provided.

There was a prompt and professional response to any concerns about people’s health, safety and welfare. Staff provided a safe service to people, some with very complex physical, mental and emotional needs.

People received a service from staff that were recruited, trained and supported to provide a safe and effective service. People were informed if a care worker might be late.

People received their medicines as needed and the service promptly sought any health care advice from community professionals.

People’s legal rights were upheld. They were involved in all decisions about their care, which was regularly reviewed.

The agency provided a service which was caring, respectful and promoted people’s privacy and dignity.

People had confidence that any issue or complaint would be handled in their best interest.

The registered manager was experienced and led by example. People’s views were regularly sought, checks made on the standards of care provided and the importance of aiming for continual improvement understood and followed through.