About the service: Blue Ribbon Care is a domiciliary care agency. It provides personal care to older adults and adults with learning disabilities living in their own homes.

People’s experience of using this service: People told us they felt safe. However, on inspection we found that people had not consistently received safe care. Staff had received safeguarding training and recognised signs and symptoms of abuse and reported them, but safeguarding concerns had not been managed effectively to protect people from risk of avoidable harm.

People’s needs were assessed and planned with them and their family when appropriate. However, quality monitoring systems had not consistently alerted the registered manager as to when routine reviews were due.

Internal policy and procedure documents had not been reviewed regularly in line with the services own criteria to ensure current best practice was being followed.

Systems were in place to ensure that people were protected by the prevention and control of infection.

Safe recruitment procedures were in place to ensure staff employed were suitable for their role. Staff received an induction prior to starting work and received on-going training to ensure they provided care based on current best practice when supporting people.

People were supported to access health appointments when required, including opticians and doctors.

People had 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. The principles of the Mental Capacity Act (MCA) were followed.

People received care that was kind and caring. People were encouraged to make decisions about their care and their privacy and dignity were protected and promoted. People had developed positive relationships with staff.

Care plans were personalised and provided staff with guidance on how to support people and their choices were respected. Information could be made available in different formats to help people understand the care and support agreed.

Rating at last inspection: Good 12 May 2016

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service is rated requires improvement overall.

Enforcement: At this inspection we found the service to be in breach of one of the Care Quality Commission (Registration) Regulations 2009 (part 4). We have asked the provider for an explanation of why they had failed to notify us of safeguarding incidents. We will review their response and undertake any appropriate enforcement action.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any information of concern is received, we may inspect sooner.

This inspection took place on 19 April 2016 and was announced. The provider was given 72 hours’ notice of our inspection because the location provided a small domiciliary care service and we needed to be sure that someone would be in the office. The service provided domiciliary care and support to people living in and around Market Harborough and surrounding villages. At the time of our inspection there were 45 people using the service.

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 requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt very safe with the staff team who supported them. Care workers had received training on how to keep people safe and they knew what to do if they felt that someone was at risk of harm. The management team were aware of their responsibilities for keeping people safe. This included referring any concerns to the local safeguarding team and the Care Quality Commission (CQC).

Risks associated with people’s care and support had been assessed. This was so that any risks could be identified and minimised wherever possible. This enabled the care workers to provide care and support in the safest possible way.

There was a robust recruitment process in place and this had been followed when new members of staff had been employed. All the required checks had been carried out so that only suitable people worked for the service.

Care workers had been provided with an induction into the service and training relevant to their role had been provided. Care workers we spoke with felt supported by the management team and they told us there was always someone available to speak with should they need any help or advice.

People using the service had been visited prior to their care and support packages commencing. This was so that an assessment of their needs could be completed. From the assessment of need a care plan had been produced and this was agreed and signed by both the person using the service and a member of the management team.

People were always asked for their consent before their care and support was provided. Care workers had received training on the Mental Capacity Act 2005 (MCA) when they had first started working for at the service and care workers we spoke with understood and applied its principles.

Care workers knew their responsibilities with regards to people’s medicines. They knew that they could only prompt medicines that were recorded on the medicine administration record and prompt medicines that had been prepared by a pharmacist.

People using the service told us that the care workers who provided their care and support were caring. They told us that they were treated with respect and their dignity was maintained when personal care was provided.

People told us that they had regular carers who visited them. They told us that the care workers knew them well, they always turned up and stayed for the right amount of time. Nobody felt rushed by the care workers who supported them.

There was a complaints process in place and this had been followed when a concern had been raised with the management team. The people using the service knew what to do if they were unhappy about the service they received, though those we spoke with had no concerns.

People using the service had been provided with the opportunity to have a say on how the service was run. This was through the use of surveys and visits to people’s homes. The staff team also had opportunities to share their thoughts of the service. This was through attending team meetings and individual meetings with a member of the management team. This showed us that the management team were interested in people’s thoughts of the service.

There wer

We spoke with three people who used the service or their representatives. Some of the people who used the service had complex communication needs and were not able to talk with us. A person told us that they were happy with the care their relative received and that they “haven’t got a bad word to say” about the service. A person who used the service told us they were happy with the service and felt "very lucky to have them” as they felt safe and could trust them.

Another person told us that staff “were punctual, we feel safe and comfortable with them and they work at our pace”.

People told us they could contact the agency at any time and that any issues or concerns would be resolved. Staff told us they were well supported and they received the training they needed.

We found that the agency regularly monitored and reviewed the service they provided to ensure that people were supported safely.

We spoke with four people who used the service. People said they were very satisfied with the service they received.

One person told us “I don’t know what I’d do without them”. A relative of a person who used the service told us that the service was very professional and very flexible and that "they go that extra mile”. Another person who used the service told us “I can’t speak highly enough of them. If there is a problem we sort it out”.

People told us they could contact the agency at any time and they would quickly resolve any concerns or issues. Staff told us they were well supported and received all the training they required.