About the service: Affexa Care Services is a domiciliary care agency that was providing personal care to 21 people living in their own homes at the time of the inspection. People had a range of support needs including those living with dementia and a physical impairment.

People’s experience of using this service:

Staff recruitment required strengthening. For example, one person was employed who had a positive disclosure and barring service check. There was no recorded rationale in place prior to their employment to ensure they were suitable to support people in their role

We have made a recommendation that the service review the NICE guidelines for managing medicines for adults receiving social care in the community and ensure medicine management systems are in line with this.

Mental Capacity Act documentation was lacking; however, staff were aware about the MCA and people told us they were consulted about their care.

Systems were in place to monitor people’s care; however, some systems could be strengthened to address key areas in the service.

People had access to healthcare professionals.

There was a sufficient amount of suitably trained staff to meet people’s needs

People were protected from potential abuse and told us they felt safe. Staff were aware of their safeguarding responsibilities.

People’s needs were assessed and they were involved with reviews of their care.

People were treated with kindness by staff and were involved in their care. People told us they were treated with dignity and respect.

People knew how to complain and the provider considered these appropriately.

People received care that was responsive to their needs. However, further detail about people’s preferences, life history and end of life wishes in their care plans required strengthening.

The registered manager was approachable and understood their duty of candour.

More information is in the full report.

Rating at last inspection: The last report was published on the 16 December 2016 and was rated Good.

Why we inspected: This was a planned inspection based on previous rating.

Follow up: The next scheduled inspection will be in 12 months. We will continue to monitor information that we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

This announced inspection took place on 6 December 2016. This was a focused inspection as we returned to check if improvement had been made since our previous inspection where we had concerns that the service was not fully safe, effective and well led. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Affexa Care Services on our website at www.cqc.org.uk.

Affexa Care Services provides personal care to people in their own homes. At the time of this inspection 18 people were using the service.

There was a registered manager in post who was also the registered provider. 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.

Improvements had been made to the way in which new staff were employed. Safe recruitment procedures were being followed to ensure that prospective new staff were of good character and fit to work with people. There were sufficient staff to safely meet the needs of people who used the service.

New external training had been arranged to ensure that staff were receiving training that was safe, accredited and specific to their job role. People were being supported with their medicines by staff who were trained and deemed competent to manage their medicines.

People were safeguarded from abuse as staff and the registered manager acted and reported potential abuse for further investigation. Risks of harm to people were assessed and minimised.

The principles of The Mental Capacity Act 2005 were being followed as people were consenting to their care. People were regularly asked their views on the service they received.

People were supported to remain healthy and to eat and drink sufficient amounts. Staff sought medical advice if people were unwell.

There were systems in place to monitor and improve the quality of the service and the registered manager had made the required improvements since our last inspection.

This inspection took place on 18 August 2016. This was the provider's first inspection since registering in December 2015.

Affexa Care Services provided personal care to people in their own homes. 18 people were using the service at the time of the inspection.

There was a registered manager in post who was also the registered provider. For the purposes of this report we will refer to them as 'the manager'. 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.’

Safe recruitment procedures were not being followed to ensure that staff were fit, of good character and qualified to fulfil their roles.

There were sufficient staff to meet people's needs and people received their agreed care at the agreed times.

People were safeguarded from the risk of abuse as staff and the manager knew what to do if they suspected a person had been abused.

When people required support with medicines they were managed safely.

The principles of the MCA 2005 were being followed as people were consenting to or being supported to consent to their care.

People received health care support when they needed it as staff knew what to do if a person became unwell.

People were encouraged to maintain a healthy diet and food and drink intake was monitored if necessary to ensure people had sufficient to eat and drink.

People were treated with dignity and their right to privacy was respected.

People received care that was personalised and met their individual needs and preferences.

There was a complaints procedure and people knew how to use it and had confidence that their concerns would be acted on.

The manager was well liked and respected by people who used the service, their relatives and staff.

The manager demonstrated a passion for their role and a commitment to improving the service being delivered to people.