This announced inspection took place on 16 June 2016. At our last inspection on 8 October 2013 they were compliant in all the regulations we looked at. 5 Care services provides personal care to people in their own homes. At the time of our inspection they were providing care to 51 people in their own homes.

There was a registered manager in place at the time of our inspection. 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 and their relatives to us they felt safe whilst receiving care. Staff had received training and were knowledgeable about how to keep people safe and were knowledgeable about how to report any concerns about people’s safety or if they suspected any abuse. Staff knew how to manage people’s assessed risks however these were not always recorded in their care records. People told us they were supported to meet their needs by sufficient staff, who stayed the correct amount of time. The provider had a safe recruitment process in place which ensured people were supported by appropriate staff. People received their medicines on time.

People and their relatives told us the staff who supported them had been trained appropriately to meet their needs. The registered manager and staff understood how the principles of the Mental Capacity Act (MCA) affected people’s care when they did not have capacity to make decisions about their care themselves. When people required support to meet their nutritional needs staff provided the support they required. People were supported to access outside health professionals when their health needs changed.

People told us they were supported by kind and considerate staff who knew them well and understood their needs. People and their relatives told us they were involved in agreeing how their care needs were to be met and received regular reviews of their care. Care records were up to date and reflected their current care needs. People were supported to maintain their independence. People told us staff respected their privacy and dignity. Staff were able to give us examples of how they ensured people’s privacy and dignity was maintained.

People told us staff provided care which was responsive to their individual needs. Staff gave people choices about their care and respected their preferences when care was delivered. People knew how to complain and when they did they were listened to and action taken to resolve their complaint.

People told us the service was well led and they would recommend the service to other people. Staff were happy working in the service because they were well supported by the registered manager. Some systems were in place to monitor the care people received. The registered manager was looking to introduce systems to look at further monitoring the care people received across the service.

We carried out this inspection as part of our scheduled inspections to check on the care and welfare of people using this service. The visit was announced, we spoke with the registered manager the day before the inspection to ensure they would be available in the office.

During the inspection we spoke with the registered manager, the managing director and one member of care staff. We telephoned and spoke with two care staff, two people who used the service and four relatives after our visit to the office.

We saw that there were arrangements in place to gain people's consent to the care and support they required. People told us they received the care they wanted and needed, records we saw also confirmed this. One person who used the service told us: "They are brilliant and so caring". One relative said: "They are a very professional organisation". Another relative said: "I have peace of mind and when we are not there I know they are being looked after".

Staff received training and support to provide people with the support they needed. They had completed induction training when they started work and had undertaken additional training to develop and improve their knowledge and skills.

The service had systems in place to review and monitor the care people received.

The service had appropriate systems in place to enable people to raise concerns and be confident that their concerns would be investigated and addressed.

This inspection was undertaken to ensure that the service was compliant with the regulations. We only looked at any outstanding actions identified during our previous inspection.

The service had required systems in place to ensure that staff were aware of abuse and actions they should undertake to respond to any allegation of abuse.

We found there were effective arrangements in place to ensure that only staff of good character were employed.

The service was compliant with the regulations and had met the requirements of the warning notice in relation to the employment of staff.

The first inspection of this service was undertaken in September 2012 when we identified that it was not compliant with three outcome areas. This inspection was undertaken to follow up compliance actions we issued following that inspection.

We found that required improvements had been made to ensure that staff received safeguarding training and were aware of action needed to protect people from harm. Staff we spoke with were aware of the signs of abuse or potential abuse and action they should undertake to protect people. We found that the service had required policies in place which informed staff about required standards of practice to protect people from abuse. We saw that these policies were also available within staff handbooks which each staff member confirmed they had received.

We found that required improvements had been made to protect people against the risks associated with unsafe management of their medicines.

The service had failed to ensure that the recruitment procedures for staff were effective and that only staff of good character were employed.

The service was registered with us in April 2011. This was the first inspection of this service.

People were treated with respect and had their privacy and dignity promoted. A relative said, "They always treat X with respect and make sure X is covered up".

The service was responsive to people's needs and had care records in place which provided staff with information about people's needs and how they should be met. A relative told us, "Staff are flexible and frequently stay longer than the allocated call time". Another relative said, "Staff go beyond expectations, nothing is too much trouble". Another relative said, "The staff member who looked after mum was so good she was very much part of the family".

Staff had all received safeguarding training. Further training will provide ongoing assurance that staff would know and undertake required actions to keep people safe when needed.

Improvements were needed in relation to the management of medicines to ensure that people received their medicines safely to promote their health and wellbeing.

Pre employment checks were not sufficient to protect people who use the service from unsuitable staff supporting them.

Systems were in place to check and monitor the quality of the service provided. One relative said, "I would definitely recommend them to others who needed care", another relative told us, "I have already recommended them to others".