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My Support and Care Services (West Country) Limited is a domiciliary care agency in Honiton for people with learning disabilities and associated needs such as autism, Asperger syndrome, and with mental health needs.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

When we visited, the agency provided personal care and support for three people and employed seven staff. People's support hours ranged from an hour a day, five days a week, up to 24 hour support, with overnight staff 'sleep in' arrangements. Some people lived in their family home and others lived independently in supported living. A supported living service is one where people live in their own home and receive care and support to promote their independence. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people's personal care and support.

Not everyone using My Care and Support Services Limited receives the regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating.

When we visited the provider was in process of buying another learning disability agency, the sale was due to complete in August 2018. The provider planned to take on providing support to the 60 people that agency supports and will employ their 18 staff. When completed, this will mean a considerable expansion in the size of this agency.

The service has a registered manager who is also the registered provider. 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.

The ethos of the service was to value each person. Staff were highly motivated to make sure each person reached their potential and lived life to the full. People were treated with utmost kindness and respect by staff, who knew people well and how they liked to be supported.

People said they felt safe and they appeared relaxed and comfortable with staff. Staff had developed caring,

kind and trusting relationships with people. People told us how their support had enabled them to become more independent and about ways in which their quality of life had improved.

Risk assessments were in place for each person which identified ways to minimise risks as much as possible. Accidents and incidents were carefully monitored, analysed and lessons learnt from mistakes. People received their medicines safely and on time.

Safe recruitment practices were followed before new staff were employed to work with people. People had a range of ways through which they could raise concerns or complaints, which were listened and responded to.

People received effective care and support from staff who were well trained and competent. People's consent to care and treatment was sought. They were supported to have maximum choice and control of their lives. Staff used the Mental Capacity Act (2005) (MCA) and understood how this applied to their practice. They supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

People's care was personalised to meet their individual needs. People had regular opportunities to raise concerns with staff day to day, and at regular individual review and customer meetings. Their views and suggestions were taken into account to improve the service.

People were supported to eat healthily and maintain a balanced diet. Health and social care professionals were regularly involved in people's care to ensure they received the care they received was right for them.

Staff were confident in the registered manager. They spoke positively about communication and how well they worked with them and encouraged their professional development. Several informal methods were used to assess the quality and safety of the service people received. The provider made continuous improvements in response to their findings.

The five questions we ask about services and what we found