Totus Care Ltd provides personal care services to people living either in their own or family home in the community. At the time of our inspection nine people were receiving care.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there were aspects of the service which were outstanding. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service demonstrated an excellent commitment to providing outstanding care which put people at the heart of everything. The provider who was also the registered manager led and inspired the staff to deliver person-centred care which put people at the heart of everything they did. This had led to consistently outstanding outcomes for people.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff continuously went the ‘extra mile’ to ensure that people lived as fulfilled and enriched lives as possible. They respected people’s individuality and enabled people to express their wishes and make choices for themselves. Positive therapeutic relationships had been developed and staff were proud of the support that they had provided to people and the positive outcomes they had observed.

People were supported to use communication aids and information was provided to people in an accessible format to enable them to make decisions about their care and support.

People who demonstrated behaviour that may challenge themselves or others received care that was based upon best practice guidelines. This met their individual needs and successfully reduced instances of incidents within people’s home and community.

Staff demonstrated the provider's values of offering person-centred care that respected people as individuals in all their interactions with people. Relatives and the professionals involved in people's care consistently told us that the service provided ‘exceptional care’ to people. People could be assured that they would be supported by sufficient numbers of staff selected to specifically to support them. Records showed that people received their care in the way they needed to maintain their safety.

People's health and well-being was monitored by staff and they were supported to access health professionals in a timely manner when they needed to. People were supported to have sufficient amounts to eat and drink to maintain a balanced diet.

Staff understood their responsibilities to safeguard people and knew how to respond if they had any concerns. Care plans contained risk assessments which gave detailed instructions to staff as to how to mitigate risks; these enabled and empowered people to live as independent a life as possible safely.

There was an effective system of quality assurance in place which ensured people had consistently received exceptional care and support. There was information available in different formats about how to complain. Relatives and staff were confident they would be listened to and appropriate action taken.

The people receiving care from Totus Care had an enhanced sense of well-being and quality of life because staff worked innovatively to enable people to have meaningful experiences and to become active members of the local community.

This domiciliary care inspection took place over three days on 15, 19 and 21 April 2016. Totus Care is a domiciliary care agency that provides care and support to people with complex needs arising, for example, from autism and learning disabilities. Support staff are provided to enable people to remain living at home in their local community.

When we inspected the service provided care and support to six people. The service is predominantly provided to people living in and around Kettering although it is not restricted to this area of Northamptonshire.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (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.

People were supported in their own homes by trained support staff that were able to meet people’s needs safely. People were also protected from the risks associated with the recruitment of support staff unsuited to the role by robust recruitment systems. There were sufficient numbers of support staff employed to meet people’s assessed needs. People or, where applicable, their representatives had been kept informed in a timely way whenever support staff were unavoidably delayed, or when another member of support staff had to be substituted at short notice.

People’s care plans reflected their needs and choices about how they preferred their care and support to be provided. Risk assessments were in place to reduce and manage the risks to people’s health and welfare.

People benefitted from receiving support from support staff that were caring, friendly, and responsive to people’s changing and often complex needs. Support staff were able to demonstrate that they understood what was required of them to provide people with the care they needed to remain living at home.

People were treated with dignity and their right to make day-to-day choices about how they preferred their care to be provided was respected. There were systems in place in place to assess and monitor the quality of the service and where appropriate and necessary people’s representatives were consulted about the service provided.

People benefitted from a service that was appropriately managed so that people received their service in a timely and reliable way. People’s rights were protected. People, or their representatives, knew how to raise concerns and complaints. There were procedures in place to ensure complaints were appropriately investigated and action was taken to make improvements to the service when necessary.