This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. It provides a service to older adults, some of whom are living with dementia, and younger disabled adults.

The inspection took place on 7 February 2018 and was announced.

The agency did not have a registered manager in place at the time of our inspection. Like registered providers, registered managers 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. The previous registered manager left the agency in October 2017. The current manager had applied for registration with CQC and had attended an interview for this role on 2 February 2018.

Prior to this inspection concerns had been raised by the local authority about the management and oversight of the agency. Safeguarding concerns were not managed appropriately and care visits were being missed. At this inspection we found the manager had worked hard to address areas of concern, which had led to significant improvements in some areas of the service. However these improvements had not extended to all areas of the service, which meant some people did not receive well planned care. We have made a recommendation that the provider implements an action plan to improve the consistency of the service and communication with people, relatives and staff.

People did not always receive a reliable, consistent service. Some people told us their care workers almost always arrived on time but others reported that their care workers were often late. They said they were not always informed if their care workers were delayed. Most staff told us they had enough travelling time between their calls but some staff said their calls were sometimes scheduled back to back, which meant they had no time to travel between calls. Most staff said they had the time they needed at each call to provide all the care people needed. However two staff told us they did not always have sufficient time to provide the support detailed in people’s care plans. Communication within the agency had not been effective as the manager was unaware of the impact of these issues on care provision and people’s experience.

People felt safe when staff provided their care because their care workers understood their needs and any risks involved in their care. Risk assessments had been carried out to ensure that people receiving care and the staff supporting them were kept safe. People told us staff maintained the security of their homes and said staff helped them keep their homes clean and hygienic. Care staff received training in the prevention and control of infection and people said staff wore appropriate personal protective equipment when providing personal care. Where people’s care involved support with medicines, this was managed safely.

There was a contingency plan in place to ensure people would continue to receive their care in the event of an emergency. Accidents and incidents were recorded and reviewed to identify any actions that could be implemented to prevent a recurrence. People were protected by the provider’s recruitment procedures. The provider carried out checks to ensure they employed only suitable staff. Staff attended safeguarding training and understood their responsibilities in terms of recognising and reporting abuse

People’s needs had been assessed when they began to use the service to ensure the agency could provide the care they needed. Staff had an induction when they started work and access to the and training they needed to carry out their roles.

People’s care was provided in accordance with the Mental Capacity Act 2005. People had recorded their consent to their care and told us staff asked for consent before providing their care on a day-to-day basis. Staff understood the importance of enabling people to make choices a