This inspection took place on 23 May 2018 and was announced. Our last inspection was sin March 2017 where we identified some gaps in staff files and we made a recommendation. We rated the service as requires Improvement, due to a history of the legal requirements not being met. At this inspection, we found that improvements had been made to staff files and improvements to overall record keeping and governance had become embedded.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, people with physical disabilities and people living with dementia. At the time of our inspection, Abletrust was providing support to eight people.

CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. Everyone using Abletrust Care receives regulated activity.

There was a registered manager 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’s care was planned in a person centred way and care plans reflected people’s needs, as well as their preferences and routines. Risks to people were routinely assessed and plans were put in place to keep them safe. Staff helped people to identify goals and we saw evidence of people’s independence being promoted through care delivery. People’s care plans were regularly reviewed and the provider ensured that people were involved in their care.

Care calls were scheduled in a way that ensured people received care at the times that they were expecting it. The provider carried out regular spot checks and surveys to gather feedback and monitor staff practice. Staff had the right training and support for their roles and received regular one to one supervision. Staff were knowledgeable about their roles in safeguarding people from abuse and we saw evidence of the provider using safeguarding concerns to learn lessons to improve practice.

People told us that staff were kind and respectful when visiting them in their homes. Staff knew how to provide care in a way that promoted people’s privacy and dignity. The provider carried out a variety of checks to measure the quality of care that people received. People were protected from the risk of the spread of infection and the provider carried out assessments of risks within people’s home environment.

People received their medicines safely and staff regularly worked alongside healthcare professionals to meet people’s needs. Staff carried out a thorough assessment of people’s needs before they received a service. Where people had specific dietary needs, care was planned in this area, Staff sought consent from people and obtained the correct legal documentation where people could not consent. We saw evidence of the provider working with relevant agencies and professionals.

People had regular contact with the registered manager and the provider had systems in place to involve people in decisions about their care. Staff felt supported by management and the provider had carried out checks on all staff to ensure that they were suitable for their roles. There was a complaints policy in place and people told us they were confident any issues that they raised would be addressed.

This inspection took place on 03 March 2017 and was announced. The provider was given 20 hours’ notice because the location provides a domiciliary care and we needed to be sure that someone would be available.

Abletrust Care is a domiciliary care agency providing support to people in their own homes. At the time of our inspection they were supporting eight people.

There was a registered manager 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.

Our last inspection was in July 2016 where we identified concerns with recruitment checks, medicines management, respect and dignity, governance and notifications. At this inspection we found actions had been taken to ensure the regulations had been met and the service had improved.

The provider had made improvements to recruitment checks. However, they had not obtained a full employment history for all staff. They rectified this following our inspection. We recommended that the provider reviews their recruitment processes. Staff were deployed in a way that meant that they were punctual and able to spend time with people.

Improvements had been made to record keeping. Care plans were person-centred and people’s needs were regularly reviewed to ensure records were up to date. The registered manager carried out regular audits and surveys to ensure people received a good standard of care. The registered manager had notified CQC of important events. We will assess whether these standards have been sustained at our next inspection.

People told us that staff treated them with respect and dignity. Staff members had undergone training to become ‘Dignity Champions’. People were offered choice and were involved in planning their care. People were supported to eat meals that they enjoyed, in line with their dietary requirements. Care plans were person centred and staff got to know the people that they were supporting.

Staff administered people’s medicines safely. Improvements had been made to medicines records and the provider carried out regular audits of medicines. Staff worked alongside healthcare professionals to meet people’s needs.

People were supported by staff who understood their roles in safeguarding people. Staff assessed risks to people and provided support that minimised risks whilst encouraging people to be independent. Staff had undergone sufficient training to support them in their roles.

People were asked for consent and offered choice. Care was provided in line with the Mental Capacity Act (2005). People told us they were confident to raise any issues about their care. There was a complaints policy in place and there was evidence that complaints had been recorded, investigated and responded to.

Able Trust Care is a domiciliary care agency which provides care and treatment to people living in their own home. At the time of this inspection the agency was providing care for 14 people.

There was a registered manager in post who was also the provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The registered manager was present during our inspection.

At our last inspection in September 2015 we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to staffing, recruitment, medicines records, respect and dignity and good governance. We asked the provider to submit an action plan to tell us how they planned to meet the Regulations. We carried out this inspection to see if the provider had taken action in line with their action plan.

The provider did not follow good recruitment processes. We found some application forms for new staff had not been completed fully. This meant the provider could not satisfy themselves that the staff they employed were suitable to work at the agency.

The registered manager did not ensure staff followed safe medicines management procedures and robust audits of medicines records had not been carried out by the registered manager. Where there had been a medicines incident the registered manager had failed to follow the requirements of their registration by notifying CQC.

Actions as stated by the registered provider in their action plan had not been completed in the timescale we were told they should be. We found continued breaches of Regulation from our last inspection.

Risks to people had not always been identified or recorded in a way that staff would know what action to take to avoid harm for people. Should people need to get hold of someone outside of office hours, they had been provided with an out of hours contact number. This could be used by both people and staff.

Care records for people were not always up to date and some information was missing. However, staff we spoke with said they knew people and found the information they had been provided with was sufficient to enable them to give the care people required.

Although the registered manager had commenced quality assurance audits since our last inspection, she had not always identified shortfalls in records. Other quality assurance processes had been introduced to obtain feedback from people as to the care that was provided to them. Staff had the opportunity to attend staff meetings to discuss all aspects of the agency.

Improvements had been made in relation to staff deployment which meant most of time staff arrived when people expected them, although we did receive mixed responses from people in relation to this. Staff were allocated travelling time between people which had not been evident at our last inspection and staff were provided with a written rota to show them where they needed to be each day.

People and relatives told us that staff were kind and caring and they were very pleased with the care the agency provided to them. However, we received some feedback which was not so positive. People had signed to show they consented to the care and treatment being provided to them.

Staff were aware of their responsibilities in relation to safeguarding people from abuse and knew how to report any concerns they may have. Staff demonstrated to us how they would support someone to make a complaint. However, people told us they were not always satisfied at the way their complaints were responded to.

Training and supervisions had been completed by the registered manager, however this was not always consistent. Staff told us however that training was good and that they felt supported by the registered manager.

People were supported to eat and drink sufficient amounts and staff always ensured food or dr

Able Trust Care is a domiciliary care agency which registered with the Care Quality Commission in February 2015. It provides care and treatment to people living in their own home. At the time of the inspection the registered manager told us they provided care to seven people, however following the inspection we learnt the agency was actually providing care to 12 people.

There was a registered manager in post who was also the provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The registered manager was present during our inspection.

The provider did not follow good recruitment processes as they could not show us they had carried out appropriate checks on new staff before the commenced work to satisfy themselves they were suitable to work at this type of service.

The registered manager did not ensure staff followed safe medicines management procedures because not all staff administering medicines had been trained. Audits of medicines records had not been carried out by the registered manager.

People were receiving late calls from staff because staff had not been deployed appropriately. There were no systems in place to provide rotas to staff to tell them where they should be or what care people required.

Risks to people had not always been identified or recorded in a way that staff would know what action to take to avoid harm for people. Staff were not aware of their responsibilities in relation to safeguarding people from abuse.

The registered manager was unable to demonstrate to us that all staff had received appropriate training. For example, manual handling. Staff did not receive formal supervisions from the registered manager.

People were involved in their own care plans, but decisions about their care were not taken into account by staff. People were being cared for by staff who did not always know them as staff were unable to give us information about the people they cared for.

Information about people’s care was contradictory or missing and the registered manager was unable to demonstrate to us they carried out any audits of care records to quality assure the service provided.

We had concerns about the management oversight of the agency as they were unable to provide us with all the information we required on the day of the inspection. However, staff told us they felt supported by the registered manager and people said the registered manager was very kind.

People had signed to show they consented to the care and treatment being provided to them. People liked the care staff who provided care to them but knew how to make a complaint should the need arise.

Staff ensured people had access to health care professionals when they needed it. Although staff did not cook for people they ensured they had access to meals when they wished them.

During the inspection we found some breaches 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.