About the service: A Plus Caring Ltd is a domiciliary (home care) care agency. It provides personal care to people living in their own houses and flats.

People’s experience of using this service:

People told us they felt the care and support they received was safe. Staff received training in safeguarding and they knew how to report their concerns internally and externally to safeguarding authorities.

People told us they could rely on staff coming to visit them, however they were not always sure what time staff would turn up. They told us recent staff`s departure meant that there were at times late visits as there was a shortage of staff. Relatives confirmed this and told us that there were occasional missed visits and staff were not always able to turn up at the agreed times.

Following the inspection, we received concerns from members of the public that the service was cancelling visits to people because they had not had enough staff to ensure staff`s absences could be covered on short notice.

Staff received training in some subjects considered mandatory by the provider, however their practical knowledge and competencies were not observed by the registered manager. Training for staff to understand how to care for people who lived with dementia was not provided.

Relatives of people who lived with dementia did not know if the support recorded in people`s care plan had been provided by staff. They told us at times they were not happy with the quality of the care provided.

People and relatives told us the registered manager had not always listened to their concerns when they raised issues with them. Concerns or complaints were not recorded or responded following the provider`s complaints policy.

People and relatives told us staff were kind and caring. People`s dignity and privacy was protected.

Care plans were developed when people started using the service, however risk assessments were not developed for each identified risk to people`s health and wellbeing.

People told us staff were adapting and were responsive to their needs and supporting them the way they wanted.

The service operated for just over a year and some of the provider`s policies and procedures needed further developing to ensure they were based on current legislation and best practice guidance.

The registered manager monitored the quality of the service through audits and feedback received from people and relatives, however there was no evidence that improvement to the service were implemented.

Rating at last inspection: This was the first inspection of the service since they registered with the Care Quality Commission on 20 December 2017.

Why we inspected: This was a planned inspection.

The overall rating for this service is ‘Inadequate’ and the service therefore is in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling thei