Day and Nightcare Assistance (HO)

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people, people living with dementia and people with physical disabilities. There were 209 people using the service at the time of the inspection.

Not everyone using Day and Nightcare Assistance receives regulated activity; the CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

There was a registered manager in post. 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.

At the last inspection on 25 April 2016, the service had been rated 'good'. At this inspection we found the service remained 'good'.

The service ensured people were safe. Risks to people had been identified, assessed and were managed safely. Staff were aware of their responsibilities and knew how to identify and report abuse. Medicines were administered safely. The registered provider followed safe and robust recruitment procedures. There were sufficient numbers of staff to support people safely.

People received effective care. Staff were supported to undertake training needed for their professional development, including nationally recognised qualifications. Staff received regular supervisions and appraisals which enabled them to develop their understanding of good practice and to fulfil their roles effectively.

Where some people were unable to make certain decisions about their care, the legal requirements of the Mental Capacity Act 2005 were followed. People were supported to have their health needs met by health and social care professionals, including their GP and dietitian. People were offered a healthy balanced diet and when people required support to eat and drink, this was provided in line with relevant professionals' guidance.

The service continued to provide support in a caring way. Staff protected people's privacy and dignity and treated them with respect. People had developed positive relationships with staff and were treated in a caring and respectful manner. People were supported to be as independent as they possibly could be.

The service continued to be responsive to people's needs and ensured people were supported in a

personalised way. Any changes in people's needs were addressed immediately. People and their relatives were aware of how to make a complaint. When concerns had been raised, they had been dealt with in line with the provider's complaints policy and procedures.

The service was led by the registered manager who promoted a service that put people at the forefront of all the service did. Staff were valued and supported by the registered manager and the provider. They were given appropriate responsibility which was continuously monitored and checked by the registered manager. A system to monitor, maintain and improve the quality of the service was in place.

The five questions we ask about services and what we found