This was a comprehensive inspection that took place on 21 November 2018. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection.

The service was last inspected in October 2017, where we found the provider to be in breach of the regulation in relation to safeguarding service users from abuse and improper treatment. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least Good. At this inspection, we found that the provider had made improvements and were no longer in breach of the regulation.

Bio Luminuex Health Care Limited is a domiciliary care service registered to provide personal care to people living with dementia, a learning disability or autistic spectrum disorder, a physical disability, sensory impairment, a mental health condition, people who misuse drugs and alcohol, older people and younger adults.

Not everyone using Bio Luminuex Health Care Limited receives 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. At the time of this inspection, the service was providing personal care to 44 people in their own homes.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and relatives told us staff were trustworthy, reliable and safe. Risks to people’s health, care and mobility were identified, assessed and mitigated. Staff were knowledgeable about risks to people and how to manage them to provide safe care. Staff demonstrated a good understanding of how to safeguard people against harm and abuse. They knew how to escalate their concerns to ensure people’s safety. People’s medicines were managed safely by staff who were appropriately trained and competency assessed. Staff followed safe infection control procedures to ensure people were protected against the spread of infection.

Sufficient and suitable staff were recruited to meet people’s needs safely. Staff received regular training and supervision to provide effective care.

People’s needs were assessed before they started receiving care and they told us their dietary needs were met. Where requested people were supported to access healthcare services.

People and relatives were involved in the care planning process. People’s care plans were comprehensive and regularly reviewed. Staff were promptly informed of any changes to people’s needs.

People told us staff were caring and treated them with dignity and respect. Staff encouraged people to remain independent and met their cultural and spiritual needs.

Staff were trained in equality and diversity, and told us they supported people without any discrimination. The provider encouraged lesbian, gay, bisexual, transgender people to use the service.

People and relatives knew how to make a complaint and they told us their complaints were addressed in a timely manner.

The provider had systems in place to support people on end of life and palliative care.

People and relatives spoke highly of the management and told us they were happy with the service. Staff told us they felt well supported and found the management approachable.

The provider had effective monitoring and auditing systems in place to ensure the safety and the quality of care. The management worked with the local authority to improve the service.

The inspection took place on 18 and 24 October 2017. This was an announced inspection. This service had not been inspected since its registration on 12 November 2015.

Bio Luminuex Health Care Limited is a domiciliary care service. The service provided personal care support to older people living in their own homes, and at the time of inspection 38 people were receiving support.

The service had 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.

People and their relatives told us they were satisfied with the service and found staff trustworthy and reliable. Risks to people’s health and care were identified, assessed and mitigated. People’s risk assessments gave sufficient information to staff on how to provide safe care. People were happy with the medicines management support and the provider maintained accurate medicines administration records. The provider followed appropriate infection control practices. There were sufficient staff numbers to meet people’s needs and the provider followed safe recruitment procedures. People were happy with staff’s timekeeping and punctuality. Although, staff were aware of what was abuse and signs and types of abuse, not all staff were aware of how and when to report abuse.

Staff received regular supervision, and sufficient training in most areas. People’s individual health and care needs were met by staff who were aware of people’s needs and abilities. The provider worked within the principles of Mental Capacity Act. People were happy with nutrition and hydration support and their cultural specific dietary requirements were met. The provider worked well with the health and care professionals to promote and maintain people’s good health.

People told us they were supported by the same staff and they were treated with dignity and respect. The provider recorded people’s cultural, religious and background history and supported them when requested to practice their religious beliefs. People’s care plans were detailed and recorded their likes, dislikes and wishes. However, the provider did not record people’s end of life care wishes. People’s complaints were listened to, recorded and responded in a timely manner.

The provider carried out regular monitoring checks and audits to identify gaps and areas of improvements and developed improvement action plans to address areas of concerns. However, the provider had not acted promptly on addressing serious issues of staff’s lack of understanding of reporting safeguarding concerns. During the inspection the provider had arranged safeguarding training and one to one supervision sessions to rectify the issues.

The provider formally sought feedback from people, their relatives and staff on an annual basis and analysed people’s feedback to improve the quality of the service.

We have made a recommendation about the management of people’s end of life care wishes.

We found the registered provider was not meeting legal requirements and was in breach of one Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to safeguarding service users from abuse. You can see what action we told the provider to take at the back of the full version of the report.