This announced inspection took place at the provider’s office on 13 June 2018 with phone calls undertaken to people with experience of the service on 14 June 2018. The provider was given a short notice period that we would be undertaking an inspection. At our previous focussed inspection in August 2017, the provider was rated as ‘Requires Improvement’ in the key questions of Safe and Well Led. The provider was in breach of Regulation 17 of the Health and social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection, we found the provider had made sufficient improvements to meet the regulations.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our inspection 51 people were receiving personal care from the provider.

Not everyone using Ave Maria receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered 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.’

People were supported by staff who were aware of their responsibilities to raise any concerns they may have in terms of people’s health and wellbeing. Where safeguarding concerns had been raised, they had been responded to an acted on appropriately.

Staff were aware of the risks to people and provided with information to assist them in managing those risks. People were supported to take their medicines as prescribed and staff competency checks were in place to ensure staff followed correct procedures.

New systems had been introduced to ensure staff were provided with travel time between calls. Calls were monitored to ensure staff arrived and left at the correct time. Accidents and incidents were inconsistently reported and the provider was putting systems in place to address this.

Pre-assessment processes in place provided staff with the information they needed to support people effectively and to meet their needs. Staff had received and induction and training that provided them with the skills to meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff presented as kind and caring and were respectful of people’s choices. People’s preferences were taken into account to ensure their dignity was maintained.

People were supported by staff who knew them well and what was important to them. People were supported to maintain their independence and encouraged to take part in activities they enjoyed.

The provider was responsive to people’s requests to change the time of some of their calls as staff worked in particular areas, providing them with the flexibility to accommodate these requests.

There was a system in place to record people’s complaints. People preferred to speak to their carers direct with any concerns, rather than contact the office.

Audits were in place to assess the quality of care but there was a lack of analysis of this information which would identify trends and help improve service delivery. New technology had been purchased to improve the quality and delivery of service. Staff felt supported and listened to. Efforts were made to obtain feedback from people who used the service.

We carried out an announced comprehensive inspection of this service on 11 October 2016 and rated the service as ‘Good’ overall.

Since that inspection we received information about concerns in relation to the service. These related to people being not being supported safely by care workers. People’s care calls were late or were missed. Some people’s medicines had not been given on time or not at all and the service did not respond to people’s complaints. As a result we undertook an unannounced focused inspection on 1 August 2017 to check whether people were safe and whether the service was well-led. This report only covers our findings in relation to these two key areas.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ave Maria Care Services on our website at www.cqc.org.uk.

Ave Maria Care Services is registered to provide personal care and support to people living in their own homes. At the time of our visit, the service provided care and support to 55 people.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered provider’s, 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 told us there was enough care staff to provide their care and they felt safe with them. People we spoke with told us overall, they were happy with the quality of service they received.

All staff had completed safeguarding adults training and they knew what action to take if they thought a person was at risk. The registered manager was aware of their responsibilities to keep people safe.

Staff had received training which provided them with the knowledge and skills needed to support people to move safely.

Risk assessments were in place but not all known risks had been assessed. Information in care records did not consistently provide staff with the information they needed to keep people and themselves safe when providing care to people. However, staff demonstrated their understanding of the risks associated with people’s care and how these were to be managed.

People received their medicines when they needed them.

All the people we spoke with and records we reviewed showed people’s care calls had taken place. However, some people were dissatisfied because care staff did not always arrive when they expected them. The scheduling, planning and monitoring of calls requires improvement.

There were systems in place to monitor the quality and safety of the service provided to people. However, not all checks were effective.

Recorded complaints had been responded to in line with the provider’s procedure.

The registered manager welcomed feedback from people and their families to improve the service they received.

Staff told us they had received awards for providing good quality care to people and were pleased their commitment and hard work was being recognised by the registered manager.

The registered manager was aware of which notifications they were required to send us by law so we were able to monitor any changes or issues at the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

This announced inspection took place on 11 October 2016. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and support to people living in their own homes and we wanted to make sure staff would be available to talk with us about the service. This was the provider’s first inspection since their registration in February 2015.

Ave Maria Care Services is registered to provide personal care and support for adults living in their own homes. At the time of this inspection visit, the service provided care and support to 55 adults.

There was a registered manager in post at the time of the inspection. 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.

The registered manager demonstrated an understanding of the importance of effective governance processes. There was a quality monitoring system to enable checks of the service provided to people and to ensure they were able to express their views so improvements could be made. However the planning and scheduling of visits required some improvement as people who used the service regularly experienced late calls.

The service reduced the risk of people being harmed and from potential abuse because the safety of people who used the service was taken seriously. Managers and staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed. Staff understood the various types of abuse, what signs to look for and knew how and who to report any concerns to. Staff also knew what action they needed to take to minimise any potential risk of harm caused through an injury or accident to keep people safe. There were appropriate arrangements in place to ensure peoples’ medicines were obtained and, where appropriate, people were supported to take their medicines safely.

Although people told us they did not always receive consistent support from the same staff, they felt staff had the skills and knowledge to meet their individual needs. Staff were recruited in a safe way and employment checks were completed before they started to work for the service. There were sufficient staff numbers on duty to meet the support needs of people who used the service. Agency staff were not used as it was recognised this could have a negative impact upon people who received the service. Staff received training and supervision and there were support processes in place to monitor their practice. Staff training was monitored and provided when specific individual needs were identified. Staff were happy with the quality of the training and were keen to learn and improve their knowledge base in order to provide effective care.

People had been involved in decisions about their care and received support in line with their care plan. Relatives were also involved in how their family member’s care was planned and delivered. People were encouraged to make choices in the support they received. Staff understood that people have the right to refuse care and that they should not be unlawfully restricted. The provider knew what appropriate action should be taken to protect people’s legal rights. Staff supported people to have drinks and, where appropriate, meals that they enjoyed.

Peoples’ needs were being met because the service worked in partnership with health and social care professionals to meet those needs. Health professionals we spoke with were happy with the standard of care provided although one professional was concerned with the inconsistency of care staff. Staff were caring, kind and treated people with dig