The inspection took place on 8 June 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults, including people living with dementia. There were 14 people using the service at the time of this inspection, two of whom were receiving live-in care.

There was no registered manager in post at the time of our inspection. The previous registered manager had left on 2 February 2018. The current manager started work on 21 May 2018 and had applied for registration with the Care Quality Commission (CQC). 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.

People felt safe when staff provided their care. Staff understood any risks involved in people’s care and managed these well.

The agency had missed some care calls in the period before our inspection, which meant people had not received a safe and reliable service. The provider had taken action to reduce the risk of further missed calls and to ensure sufficient staff were available to carry out all scheduled calls. We made a recommendation that the provider implement a call monitoring system which would alert the office if a care worker failed to arrive for a scheduled visit.

There were procedures for staff to follow if they were unable to contact a person when they arrived to provide their care. Staff had access to management support and advice when they needed it, including out-of-hours.

There were plans in place to ensure people’s care would not be interrupted in an emergency. Incidents and accidents were recorded and reviewed to identify what action could be taken to prevent a recurrence.

The provider had appropriate recruitment procedures to help ensure they employed only suitable staff. Staff attended safeguarding training and understood their responsibilities in terms of recognising and reporting abuse.

Medicines were managed safely. Some shortfalls in medicines recording had been identified in a recent audit but the manager had taken action to ensure these were addressed.

Staff maintained appropriate standards of infection control. Staff helped people keep their homes clean and hygienic and wore personal protective equipment when providing care.

People’s needs were assessed before they used the service to ensure staff could provide their care. People were encouraged to contribute to their assessment to ensure they agency understood their needs and preferences.

Staff had access to the training and support they needed to do their jobs. Staff attended an induction which included all elements of mandatory training and had access to additional training relevant to the needs of the people they cared for. Staff had opportunities to meet with their managers to discuss their performance and training and development needs.

People’s care was provided in accordance with the Mental Capacity Act 2005. Staff understood the importance of consent and respected people’s choices about their care. If people lacked the capacity to make decisions, relevant people had been consulted to ensure any decisions were made in the person’s best interests.

People’s nutritional needs were assessed when they began to use the service. A care plan was developed to meet any identified dietary needs and specialist professional input obtained where necessary.

Staff monitored people’s healthcare needs and responded appropriately if their health deteriorated. Staff accompanied some people to healthcare appointments and communicated with healthcare professionals where people wished them to do so.

Staff were kind and caring. People had developed positive relationships with their care workers and enjoyed their company. Relatives said staff treated their family members with respect and maintained their dig