Team Medical (Southampton) Limited is a domiciliary care agency providing personal and nursing care to people living in their own homes with complex medical needs, including brain injuries. At the time of the inspection the service was supporting 24 people with personal care. The agency was not providing the regulated activity of nursing care at this time but nurses were available if necessary. This was the first inspection of the service at this address.

The inspection took place on 13 and 18 October 2016 and was announced.

There was a registered manager at the service. 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.

People felt safe when they were supported by staff. Staff had completed training with regard to safeguarding people. Risk assessments were undertaken to identify and minimise risks to people’s health and wellbeing and were updated annually or sooner if necessary. People’s needs were met by enough staff who worked in teams to ensure shifts were covered. The provider sought references and completed pre-employment checks before new staff could start work. People received support from staff to take their medicines as prescribed.

People were supported by staff who had completed appropriate training and could access bespoke training, relevant to people’s needs. Staff were supported in their work through supervision, spot checks and appraisal. Staff had training in and understood legislation designed to protect people’s rights. People were supported to eat and drink in ways which met their needs. Staff supported people to visit the GP and the dentist when appropriate.

Positive caring relationships were developed with people using the service. People were encouraged to express their views and be actively involved in making decisions about their care and support. People’s privacy and dignity were respected and promoted by staff who understood how to support people with their personal care.

People received personalised care and support which was responsive to their needs. Initially, people’s needs were assessed and this formed the basis of their care plan. People’s care plans were detailed and showed people’s needs, wishes and preferences and informed staff how people wished to be supported. The provider had a complaints procedure in place and people and/or their relatives knew how to complain if they were not happy with the service provided. Complaints were investigated and responded to as well as changes made to improve the service.

The registered manager promoted a positive culture which was person-centred, open, inclusive and empowering. The registered manager had systems to monitor the quality of the service provided which included auditing the completion of records and following up issues identified. The provider sought the views of people using the service, their friends and family, as appropriate, through a system of spot checks, regular visits and an annual questionnaire which sought people’s views about the specific staff who supported them. Action was taken, as necessary to improve the experience of people receiving care and support.