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Inspection carried out on 22 March 2016

During a routine inspection

The inspection took place on 22 March 2016 and was announced. The service is registered to provide personal care and is a domiciliary service. There were twenty people receiving care at the time of the inspection.

The service has a registered manager. 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.

The service was outstandingly well-led which was demonstrated by how the staff were supported and how well the service was organised to ensure people received high standards of care according to their assessed needs. People told us the service was great, while another said it could not better. Communication between the service and people were good. People told us they liked having the same carers and said they went the extra mile for you when needed. Another person said they could not praise the staff enough. They said the service provided the two qualities they were seeking which were it was trustworthy and reliable. The care plans were person-centred written to clearly identify the support required alongside what the person could do for themselves.

Staff had attended training designed to help them recognise abuse and know what actions to take to protect people as far as reasonably possible from actual or potential harm, or abuse. Staff had a very good understanding of their roles and responsibilities. People using the service were supported by a sufficient number of suitably experienced staff. The manager carried out appropriate recruitment checks before staff began work with the service. Staff had been recruited safely and had the skills and knowledge to provide care and support in ways that people preferred. As part of the assessment process to determine if the service could meet the individual’s needs, people were asked about their preferences and choices.

The service had a medicines policy, staff had received training and systems were in place to manage medicines and people were supported to take their prescribed medicines safely.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Staff had been trained and had a good understanding of the requirements of the Mental Capacity Act 2005 and in particular Best Interest Meetings.

Positive and caring relationships had been developed between people and staff. Staff responded to people’s needs in an understanding and empathic manner. People’s choices were respected as was their privacy and dignity. The care plans were written to take account of people’s needs and to promote and maintain independence. People were involved in the planning and reviewing of their care and support, as were family members with their permission.

Staff knew people well and were trained, skilled and competent in meeting people’s needs. Staff were supported and supervised in their roles and had annual appraisals to discuss their performance and career development. Part of the supervision process was for the service to carry out spot checks of the care delivery.

Staff supported people with their health care needs including where required monitoring of people’s food and fluid intake. The service reviewed people’s care to ensure the service continued to meet their needs and they worked with other professionals to ensure needs were met as comprehensively as possible. The service arranged community activities for the people to meet each other and take part in at no cost to themselves

We considered the service was good in the way that it had developed person-centred care plans. In turn this had led to identifying that people had become isolated in their own homes within the community and the service had started to support people to address these issues through arranging and linking into local events.

The staff told us there was an open culture as the manager was approachable and enabled people who used the service to express their views. People were supported to report any concerns or complaints and they felt they would be taken seriously. People who used the service, or their representatives, were encouraged to be involved in decisions about the service. The service had systems in place to check the quality of the care provided which included surveys to gauge and understand people’s views who used the service.