This announced inspection took place on 26 September 2017. Capital Staffing Services Ltd provides personal care and treatment of disease, disorder or injury to people in their homes. At the time of our inspection, 17 people were using the service.

This is the first inspection of the service since registration with the Care Quality Commission in August 2016.

There was 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 received care and support from trained and skilled staff comprising of registered nurses and care assistants. The provider provided training to relatives of people using the service who were actively involved in care delivery and worked alongside their staff. Staff received support to undertake their roles. While the registered manager monitored and supervised staff’s practice, they did not always maintain up to date supervision records. There was a risk that the registered manager could miss an opportunity to identify and follow up on staff development needs.

People received care and support from staff who knew how to identify abuse and understood their responsibility to report any concerns. Staff managed identified risks to people’s health and well- being. The registered manager worked with other healthcare professionals to minimise the risks of foreseeable emergencies to people using the service in relation to the adequacy of staffing levels, medicines and medical equipment used in their homes.

People received care and support from sufficient numbers of staff. The provider ensured there was a mix of staff with the right competencies, experience and skills deployed to meet people’s needs. The provider followed appropriate recruitment procedures to employ staff suitable to provide people’s care. People who required support to take their prescribed medicines received appropriate assistance in line with best practice and current guidance. Staff minimised the risks of infection to people by following good standards of hygiene.

People using the service and their relatives were happy with the care and support they received. People had their care delivered in a caring and compassionate manner. Staff maintained people’s privacy and dignity when they delivered care and support. People received the support they required to lead independent lives, undertake activities of their choice and to maintain relationships that mattered to them.

People had appropriate support to eat and drink healthily in line with their nutritional and hydration needs. Staff supported people to access healthcare services to maintain their health and monitor their well-being in a timely manner.

People gave consent to care and treatment. People using the service and their families (where appropriate) were involved in planning and making decisions about their care. Staff understood the support people required and respected their decisions about how they wanted to receive care. People who were unable to make decisions about their care received appropriate support through best interests meetings.

The registered manager carried out a needs assessment before each person started to use the service. Care plans showed details of people’s needs and the support they required. People received care that responded to their changing needs and preferences.

People benefited from a person centred, transparent and honest culture that prevailed at the service. The registered manager and provider encouraged people and their families to talk about their experiences of using the service and to share ideas about how to improve care provision. People using the service and their relatives knew how to make a complaint if they were unhappy