This comprehensive inspection took place on 11 July 2018 and was announced. The registered provider was given short notice of our inspection. We did this because the service is small and the manager was sometimes out of the office and we needed to be sure that they would be available. The service was last inspected on 10 and 11 April 2017. At our last inspection we found the registered provider in breach of three Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations; Regulation 19, Fit and proper persons, Regulation 18, Staffing and Regulation 17, Good governance. The overall rating of the service was requires improvement.

Following our last inspection the registered provider sent us an action plan with details of the improvements they planned to make to meet the requirements of the regulations.

Access Support – SADACCA (Sheffield and District African Caribbean Community Association) Ltd is a small domiciliary care service registered to provide personal care for people living in their own homes in the community. At time of the inspection the service was providing a home care service to three people

The manager had applied to register with the Care Quality Commission. 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.

Since the last inspection, the director had outsourced all the staffing to another company called Watoto Enterprise Ltd. The manager of this company was responsible for the recruitment, employment, training and supervision of the staff. The director told us seven staff from this company were providing care to people using the service. This decision to outsource the staffing at the service was not meeting the registered providers ‘Statement of Purpose’ which states ‘We take great care in recruiting, training and supervising our staff who have a wide range of qualifications’.

People did not have risk assessments in place, to ensure that potential risks to people were managed and minimised. One person who had been using the service for two months did not have risk assessments or a care plan in place. They had computerised care records that staff completed at each visit.

At our last inspection we found concerns about the recruitment of staff. At this inspection there was insufficient evidence to show recruitment processes were being operated effectively because the service did not employ any care staff.

The systems in place to manage medicines required improvement in some areas.

We found the arrangements in place for a person who had monies managed by the service needed to be improved.

The service had a process in place for staff to record accidents and untoward occurrences. However, the service was relying on staff working for another company to report these occurrences.

People we spoke with during the inspection were satisfied with the quality of care that had been provided.

People we spoke with told us they were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, as the service did not employ their own staff, we were unable to check staff fully understood the requirements of the Mental Capacity Act 20015.

Staff training records the registered provider had for the Watoto staff showed they had not completed all the relevant training.

We were unable to determine whether staff were being supported to deliver care and treatment safely and to an appropriate standard, because we were unable to access supervision and appraisal records for staff employed by another company.

People had not been given a copy of the complaints procedure. They told us they would contact the local authority or speak with a famil

SADACCA (Sheffield and District African Caribbean Community Association) is registered to provide personal care to people living in their own hiomes in the city of Sheffield. The office is based near the city centre, close to transport links. At the time of this inspection SADACCA was supporting four people whose support included the provision of the regulated activity ‘personal care’.

There was a manager at the service who was in the process of registering with CQC. 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 and associated Regulations about how the service is run.

Our inspection was discussed and arranged with the service director and manager two days in advance. This was to ensure we had time to visit and contact people who used the service and speak with the director, manager and staff.

Without exception people who received care and support from the staff at SADACCA said they felt safe and well cared for.

Although there was a policy and procedure for the safe recruitment of staff, people could be put at risk because full and thorough information was not obtained about staff before they were offered a job at the service.

Prior to people being supported with their care an assessment of need was completed. Any risks were also identified. However further information about how the risk could be eliminated or reduced were not recorded in a risk assessment format.

We found people were protected against the risks associated with medicines because the registered provider had appropriate arrangements in place to manage medicines.

There were enough staff employed to make sure all visits were carried out at the agreed time and people told us staff always completed all their tasks before they left.

Although staff felt supported by the director and manager of the service they were not provided with a formalised programme of supervision which would help to ensure their competency was maintained.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and the principles of the Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

Where appropriate staff assisted people to maintain suitable and nutritious food and hydration.

People’s privacy and dignity were respected by staff. People told us staff supported them in a sensitive and discreet manner.

People were assessed prior to the them receiving a service which meant staff were confident they were able to meet their needs. Care and support provided to people was person centred and individual to the person.

People receiving support and their relatives were aware of the complaints policy and said they were confident to use this if they had any worries or concerns.

Some documentation which related to the management of the service required improvement. For example, audits of accidents and incidents and spot checks of staff were not recorded in writing to evidence they had been completed.

Everyone we spoke with told us they would recommend this service to a friend or relative.

We found three breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in regulation 19: Fit and proper persons employed, regulation 18: Staffing and regulation 17: Good governance.

You can see what action we told the provider to take at the back of the full version of the report.