About the service:

Abhi Rose Homecare is a domiciliary care agency that provides personal care for adults living in their own homes in the community. People who use this service have a wide range of needs including older people who are living with a diagnosis of dementia, mental health needs, learning disabilities and physical disabilities. CQC only inspects the service being received by people provided with personal care. At the time of our inspection 40 people were receiving support from this provider.

People’s experience of using this service:

• We have made a recommendation about quality monitoring.

• People told us they felt safe with the staff who supported them. Staff understood their role and responsibility to keep people safe from harm.

• Medicine management was safe. Staff received training and their competency was checked before they could administer medicines.

• Safe recruitment processes and procedures were in place. Employment checks were completed before staff started working in the service.

• People using the service spoke fondly and with regard of the staff who provided their support and the office team, registered manager and provider. People told us staff treated them with dignity and respect and were kind and caring.

• Staff knew what to do to keep people safe. Individual risks had been assessed and identified as part of the support and care planning process.

• People were supported by staff who were motivated, enjoyed their job and felt well supported through regular supervisions assessments of their competency and training.

• Staff worked closely with a range of community healthcare professionals to make sure people’s health needs were met.

• People, their relatives and staff could approach the management team if they had any concerns. The provider had a complaints procedure in place which explained how people could raise concerns. The service had acted appropriately when any concerns and complaints had been made.

• For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At the last inspection the service was rated requires improvement (report published 5 February 2018).

The service had improved overall since our last inspection from a requirements improvement service to one that was good overall. The service met the characteristics of good in four out of five domains and requires improvement in one domain.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. We saw improvements had been made since our last inspection and the provider was no longer in breach of the regulation relating to good governance.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection of Abhi Rose Ltd took place on 23 November 2017 and was announced.

This was the service’s first inspection since their registration with the Care Quality Commission during March 2016.

Abhi Rose Ltd is a domiciliary care agency that provides personal care for adults. People who use this service have a wide range of needs including older people who are living with a diagnosis of dementia, mental health needs, learning disabilities and physical disabilities. At the time of our inspection 24 people were receiving support from this provider.

The service had a registered manager in place. 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.

During this inspection, we identified the service was in breach of regulations in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because effective systems and processes were not in place to monitor and improve the quality and safety of the service.

Staff had received training and assessed competent to administer medication. Medicine supporting documents were not retained with the medicine administration record (MAR) for audit purposes. We found medicine administration records were not audited on a regular basis.

People and their relatives told us they felt safe. Staff had received safeguarding and whistle-blowing training and knew what to do to keep people safe.

Safe processes were in place for the recruitment of staff. Risk assessments were in place and people were protected from the risks association with infection control.

People received effective support and care. People and their relatives felt staff had the right skills to do their job effectively. Staff received induction and appropriate training.

People were supported to main independence and have control of their lives. People were supported to maintain their religious beliefs.

Mental capacity assessments were in place in care plans and staff demonstrated a good understanding of the principles of the MCA and how this related to their daily duties.

People we spoke with told us staff were caring. Staff treated people with kindness and compassion. People were supported to remain independent.

Care and support plans were person centred and detailed. Care plans took into account people’s religious, ethnic and cultural needs. People and relatives were involved in their care planning. People’s privacy and dignity was respected. Care plans and records were securely stored.

Care plans were reviewed on a regular basis and updated when necessary.

The service had a complaints policy in place. People and relatives told us the service would contact them by telephone to see if they had any concerns. People told us the service was well led.

People were supported at the end of their life. The service had an end of life policy in place.

We found audits were not undertaken to review and improve the service provided.

Staff told us there was an open culture and felt supported by the managers.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.