Next Steps Community Care LTD

The announced comprehensive inspection took place between the 7 and 9 February 2018. We gave the service 48 hours' notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

The rating at our previous inspection was good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

A registered manager was 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.

People were kept safe by staff who knew how to recognise and report any potential harm. A sufficient number of staff were in post and any new staff continued to be recruited in a safe way. Risk to people were identified and managed. Trained and competent staff administered people's medicines safely. Infection prevention and control systems were in place and staff cared for people as hygienically as practicable. Systems and processes were in place that enabled the provider to take on-board any learning when things did not go as planned.

Staff were trained and had the skills they needed to meet people's assessed care and support needs. People were supported with their nutritional and health care requirements. Staff worked with external stakeholders who were also involved in people's care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People continued to be cared for with dignity and respect by staff who showed them compassion. People's preferences were respected by staff who knew each person well and how to meet these. Staff promoted people's privacy and people could be as independent as they wanted to be.

People's care was person centred and their records reflected this. People were treated equally no matter what their needs were. Concerns were acted upon before they became a complaint. People were given accessible ways to raise concerns. Policies and procedures were in place as guidance for staff should any person require end of life care.

The registered manager led by example and they had maintained an open and honest staff culture. Staff were aware of the standard of care that was expected. People, relatives and staff had a say in how the service was run. The registered manager remained aware of their responsibilities. Staff were supported in their role. Quality assurance, audit and governance systems were effective in driving forward improvement. The service and its staff team worked in partnership with others and people's wellbeing benefited from this.

Further information is in the detailed findings below.

The five questions we ask about services and what we found