This announced inspection took place on 20 and 24 September 2018. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to make sure someone would be available to speak with us. This was the first inspection since the service registered with the Care Quality Commission on 20 September 2017.

Ami Home Care Limited 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 people including those living with the experience of dementia, people with mental health needs, people with a sensory impairment, to younger adults and to people with a physical disability and/or learning disabilities. The service offers support to people who require help with day to day care including personal care, meal preparation, outreach services and companionship. When we inspected, the service was supporting 11 people, seven of whom were receiving personal care.

The service is required to have a registered manager and there was one in post who was also a director of the company. 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.

Monitoring processes had not always been robust in identifying shortfalls to be addressed. The provider took action to amend this and was able to show us the processes that they were going to follow to monitor aspects of the service more effectively.

People and relatives confirmed staff kept people safe when providing them with support and care.

Staff and the provider knew how to report any suspicions of abuse. Policies and procedures for safeguarding people were in place.

Risk assessments identified risks to individuals and any environmental risks so they could be addressed.

Recruitment checks were carried out to confirm prospective staff were suitable to work with people. People had the same care workers to provide continuity of care and there were enough staff to meet the needs of the people using the service.

Staff received medicines training prior to supporting people with their medicines and knew how to do this safely. Staff confirmed they followed infection control procedures to protect people from the risk of infection.

People were assessed by the provider to identify their needs and wishes, so these could be met. Staff had undertaken training to equip them with the skills and knowledge to understand and care for people’s individual needs effectively.

Staff helped people with simple meal preparation and said they would report if someone was not eating and drinking sufficiently. People’s health needs were identified and staff knew the process to follow if someone became unwell, including summoning the emergency services if required.

The provider understood their responsibility to act within the requirements of the Mental Capacity Act 2005 and to provide care and support in people’s best interests.

People and relatives said the staff were caring and understood people’s individual needs and wishes and communicated well with them. They said staff treated people with respect and maintained their dignity.

Staff supported people to maintain as much independence as they were able and respected their right to make choices about the care and support they received.

Care records were personalised and reflected the care people wanted to receive. Some discrepancies in information were addressed during the inspection. They included information about their lifestyles and interests and where relevant any religious and cultural needs so staff could respect these.

The provider had a complaints procedure. People and relatives said they felt confident to raise any concerns and that issue