We carried out an announced inspection of Barmat Healthcare Limited on 13 December 2017. This service is a domiciliary care agency. It provides personal care to older people living in their own houses and flats. At the time of the inspection, the service supported a limited number of people with personal care. This was the first inspection of the service since they registered with the Care Quality Commission (CQC).

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 providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is managed.

Medicines were not being managed safely. Medicines as needed (PRN) had not been recorded accurately. A person had not been receiving a prescribed medicine. Staff had been trained in how to administer medicines safely. We found that medicine competency checks to ensure staff were able to safely administer medicines, were not carried out by the registered manager.

Spot checks had been carried out to observe staff performance to ensure people received the required care and support. However, the outcome and findings of the spot checks had not been recorded. The quality assurance system in place was not effective in identifying the shortfalls we found with medicines and record keeping during the inspection.

Risks had been identified and information had been included on how to mitigate risks to ensure people received safe care. Staff were aware of how to identify abuse and knew who to report abuse to, both within the organisation and outside the organisation. Pre-employment checks had been carried out to ensure staff were fit and suitable to provide care and support to people safely. Staff told us they had time to provide person centred care and had enough staff to support people. There were systems in place to reduce the risk and spread of infection. Staff had been trained on infection control and were provided with personal protection equipment to ensure risks of infection were minimised when supporting people.

Staff had received training required to perform their roles effectively. People were cared for by staff who felt supported. Staff had been trained on the Mental Capacity Act 2005 and knew the principles of the act. People’s care and support needs were assessed regularly for effective outcomes. The service worked with health professionals if there were concerns about people’s health. Staff could identify the signs people gave when they were not feeling well and knew how to raise any concerns.

People told us that staff were caring, they had a positive relationship with them and their privacy and dignity were respected. People were involved with making decisions about their care.

Care plans were person centred and detailed people’s preferences, interests and support needs. People knew how to make complaints and staff were aware of how to manage complaints.

Staff told us the culture within the service was open and transparent and told us the service was well-led. People and staff were positive about the registered manager. People’s feedback was sought from review meetings.

We identified breaches of regulation relating to medicines. You can see what action we have asked the provider to take at the back of the full version of this report.