The inspection was announced and took place on 24 October 2018. At our last inspection in October 2017, we found the service to be ‘requires improvement’. At this inspection, we found that some improvements had been made and the service is now rated ‘good’. However, further improvements were still needed in relation to whether the service is well-led.

We gave the provider 48 hours of our intention to undertake the inspection. This was because the service provides domiciliary care to people in their own homes and we needed to make sure someone would be available at the office to speak to us. At the time of inspection, the provider was providing personal care and support to three people.

Actual Care Services is a domiciliary care service which is registered to provide personal care to people living in their own homes. The registered provider manages the service with care provided by a small team of staff. 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. At the time of our inspection, three people were receiving care and support services.

The provider had not carried out sufficient checks and audits to ensure themselves that the quality of the service was consistently high. Staff had not completed all mandatory training as required by the provider.

People felt safe with the staff that were supporting them and reported that staff were consistently on time and not rushed. Staff understood about potential risks and types of abuse and knew how to report concerns.

Staff were recruited using processes that ensured they were suitable to work with people and records showed that people received their medication at the right time.

People were supported by staff who understood their needs and were knowledgeable and skilled. Staff received good support from managers and felt they were well trained to carry out their roles.

People’s health was promoted by preparing food that was in line with their preferences and by ensuring people had access to drinks.

People were involved in decision making and care planning and the provider ensured that people’s preferences were known and met. Staff were caring and respectful towards the people they were supporting and were motivated to provide a high quality service.

People and relatives had the opportunity to raise concerns and complaints and reported that the provider responded to their worries quickly and effectively. People were supported to attend activities and special occasions through the flexible allocation of staff.

People and relatives were very happy with the way the service was led and staff told us that they enjoyed working for the provider

The inspection was unannounced and took place on 12 October 2017. Actual Care Services registered with the Care Quality Commission in September 2016 and this was the first inspection. We gave the provider 48 hours’ of our intention to undertake the inspection. This was because the service provides domiciliary care to people in their own homes and we needed to make sure someone would be available at the office.

Actual care services is registered to provide personal care to people living in their own homes. The registered provider manages the service with care provided by a small team of staff. 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. At the time of our inspection one person received care and support services and because of this and the fact that we want to protect this person’s rights to a private life, the report will provide an overview rather than specific examples.

Staff were able to tell us of the needs of the people they provided care for and their roles and responsibilities in keeping people safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe.

People had their individual risks assessed and had plans in place to manage them. Medicines were administered by staff to support people’s health needs and records were completed to record this.

The registered provider had arrangements in place to make sure that there were sufficient and regular staff to provide support to people in their own homes. People said staff arrived on time and stayed for the allocated time.

Staff had not received certified training. Training was provided by internal staff who were not qualified to provider training. The registered provider could not be assured of the effectiveness of the training provided.

Staff understood they could only care for and support people who consented to being cared for. People had developed good relationships with staff who they said were caring. Staff treated people with privacy and dignity and respecting people’s homes and belongings.

People were involved in how their care and support was received and were had regular opportunities to feedback about the service.

Relative’s and staff knew how to raise concerns and the registered provider had a system in place to deal with any complaints. Relative’s said staff listened to them and they felt confident they could raise any issues should the need arise and action would be taken.

Governance systems were not effectual in ensuring that effective training had been provided to staff and audits were not in place to monitor that people received their medicines to safely meet their health needs. The registered provider had not fulfilled their duties to ensure that CQC were informed of any changes to the service they provide and needed to update their information on the age range of people they provided support and care to.

Staff and relatives spoke positively about the management of the service and the said it was well run for the people it supported. Staff were well supported by an approachable management team.

The registered provider completed a number of spots checks to assure themselves of the quality of care being delivered and kept their knowledge up to date by attending provider meetings and researching online guidance.