This inspection took place on 12 June 2018 and was announced giving 48 hours' notice to ensure the registered manager was available.

At the last inspection on 16 November 2017, we found that the provider was in breach of Regulation 9 (Person centred care), Regulation 10 (Dignity and respect), Regulation 11 (Consent), Regulation 12 (Safe care and treatment), Regulation 17 (Good governance), Regulation 18 (staffing) and Regulation 19 (Fit and proper persons). We rated the service as ‘Requires improvement’ in safe, effective, caring, responsive and ‘Inadequate’ in well led with an overall rating of ‘Requires improvement’.

Following the last inspection, we met with the provider on 15 December 2017 to discuss our findings and asked them to complete an action plan to show what they would do and by when to improve all the key questions to at least ‘Good’.

We found significant improvements had been made to the service when we returned on 12 June 2018 and the service was no longer in breach of the Regulations. We have judged their rating to be 'Good'.

Annies Homecare Services is a domiciliary care service and is registered to provide personal care to people in their own homes. At the time of the inspection, there were 43 people using the service and 21 care staff supporting them.

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.

Systems to protect and keep people safe had been improved through the review and implementation of risk assessments, medicine administration and quality assurance processes. Staff knew how to protect people from the risk of harm.

The service had improved the way in which they recruited staff and they had sufficient staff to meet people’s needs. People received their medicines safely as prescribed and the records had been improved to make the management and administration more effective. Staff had an understanding of how to minimise the risk of infection, they had been trained, and had access to personal protective equipment such as gloves and aprons.

People’s care needs had been assessed and their care plans reviewed as their needs changed. Staff had received all necessary training and supervision and they knew how to support people effectively. People were supported with a healthy diet and sufficient fluids. Staff ensured people’s healthcare needs were met. The service worked well in partnership with other professionals to ensure that people received the health care support they needed.

The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) to ensure that people had as much choice and control over their lives as possible. The service had carried out appropriate assessments in line with legislation.

People were supported by kind and caring staff. Their independence was encouraged as much as possible while minimising any risks to help keep them safe. People felt staff gave them the time they needed and respected their dignity and privacy.

People and their relatives were very complimentary about the service. They told us they were kept involved in decision-making and had good contact with the management through visits and calls.

People received care that was responsive to their needs. Care plans had been improved as they were now written in a personalised, detailed and respectful way. There was a good complaints procedure and people had confidence that any complaints would be dealt with quickly.

Action had been taken to manage the oversight of the service and the improvements made meant it was well led and managed. People knew who the registered manager was, and had confidence in them. Staff told us that improvements had been made as

On 14 September 2016 we inspected Annies Homecare Services Ltd and found them to be in breach of one regulation under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breach of Regulation 17 was in relation to the lack of management systems for the monitoring of the health, safety and welfare of people. We rated the service as ‘Requires improvement’ for Well Led and ‘Good’ in the four other key questions with an overall rating of ‘Good’. We asked the provider to complete an action plan to show what they would do and by when to improve the key question Well Led to at least 'Good'.

We undertook an announced focused inspection of Annies Homecare Services on 10 November. This inspection was done to check that improvements to meet the legal requirements after our September 2016 inspection had been made. We saw that whilst some actions had been taken, there had been minimal improvements made. We therefore returned on 16 November 2017 to undertake a comprehensive inspection. We found that the service was still in breach of Regulation 17 as the required improvements had not been made. In addition, we identified breaches of Regulation 9 (Person centred care), Regulation 10 (Dignity and respect), Regulation 11 (Consent), Regulation 12 (Safe care and treatment), Regulation 18, (staffing) and Regulation 19 (Fit and proper persons). You can see what action we told the provider to take at the back of the full version of the report.

Annie's Homecare service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older and younger adults. On the day of our inspection, 52 people were using the service.

A registered manager was in place. 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 were at risk because the provider did not have robust processes in place for keeping people safe. Risks to people’s safety were not assessed or sufficiently detailed to understand their needs and to minimise risks to their health and wellbeing.

Staff were not recruited safely with the necessary checks in place and in line with the legal requirements to ensure they were safe to work with people in the community.

Medicines were not being administered or managed correctly and people were at risk of not having their medicines as prescribed and at the correct time. Investigations and lessons learnt were not always undertaken when incidents and accidents occurred. Infection control procedures were not sufficient to support staff in carrying out their role safely.

People’s needs were not holistically assessed to achieve effective outcomes for them. A system for the training and supervision of staff was in place but this was not sufficiently robust to ensure staff had the necessary information, skills and knowledge to carry out their role effectively. Staff had not received sufficient training to support people at the end of their life.

People’s capacity to make day to day decisions was not assessed or recorded and their consent about their care and support arrangements was not obtained to ensure their wishes were carried out.

People were not always treated with dignity and respect or their privacy maintained. The involvement of people and their families in the planning and decisions about their care were minimal as care plans were not person centred and did not identify people’s communication needs, wishes or views.

The management of the service was not well led. The leadership did not promote an open and positive culture. There was not a robust system in place to monitor measure and review the quality and delivery of the service or involve and engage with sta

We carried out an announced inspection on 14 September 2016.

Annies Homecare Services is a domiciliary care service and is registered to provide personal care to people in their own homes. On the day of our inspection, there were 74 people using the service and 37 staff supporting them.

There was a registered manager in place. 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.

Quality assurance arrangements were in place but there were improvements needed in relation to the review of care records and communication and involvement of staff.

The visible leadership of the service showed that person centred care was being delivered to people who used the service.

The service had appropriate systems in place to protect people from harm and uphold their rights. Staff had a good understanding and knowledge of safeguarding procedures and were clear about the actions they would take to protect the people they supported.

People’s medicines were given to them safely and in a timely way and risks to people’s health and wellbeing were appropriately assessed and managed.

There were sufficient numbers of staff available to meet people’s needs. A recruitment process was in place to protect people and staff had been employed safely. Staff had the right skills and knowledge to provide care and support to people. Staff were supported in their role and received supervision.

People were supported to have meals of their choosing which met their nutritional needs. They were treated with kindness and respect by staff and their dignity was maintained.

Staff understood people’s needs and provided care and support accordingly. Caring relationships had been developed and people were fully involved in their care arrangements.There was a system for responding to complaints and concerns.