The inspection took place on 25 October 2017 and was announced. The provider was given short notice of the inspection in line with our current methodology for inspecting domiciliary care agencies. The last comprehensive inspection took place in August 2015, when the provider was meeting the fundamental standards and was rated Good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Care 4 U Care Limited’ on our website at www.cqc.org.uk.

Care 4 U Care Limited is a domiciliary care agency who provides personal care to people who live in their own homes. At the time of our visit the provider was supporting approximately 60 people. The office is situated in the Manvers area close to Wath-Upon-Dearne.

At the time of our inspection 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.

The management team worked together to ensure care packages were completed as agreed and that staff were supported to do this. The registered provider had systems in place to monitor the service although these were not always documented effectively.

The management team listened to people who used the service, their relatives and staff to gain feedback about the service provided.

The service had a procedure in place to safeguard people from the risk of abuse. Staff we spoke with could explain what they would do if they suspected abuse.

Risks associated with people’s care had been identified and plans put in place to reduce any hazards and minimise the risk from occurring.

The registered provider had a system in place to ensure people received their medicines as prescribed. Staff told us they received training in this subject and the management team ensured they were competent to administer medicines.

The service had a safe recruitment system in place. This enabled the provider to select staff that were suitable to work with vulnerable people. Staff received an induction which included mandatory training and shadowing experienced care workers.

We saw that staff received training and support which gave them the skills and knowledge to complete their role well. Records of training attended were maintained and updated when staff completed training. Staff spoke highly of the support they received from the management team.

We spoke with people who used the service and they told us the care workers always asked their consent prior to completing care tasks. Where people lacked capacity, their representatives were involved in making decisions in the person’s best interest. However, this information was not documented.

Some people required support to ensure they received adequate nutrition. Staff were knowledgeable about people’s needs and told us they left drinks and snacks for people where required.

Staff told us that they would seek the guidance of healthcare professionals as required. They told us they would speak with people’s families and inform the management team if they had any concerns about anyone’s health.

During our inspection we visited people who used the service and spoke with some people over the telephone. People told us the staff were very kind, caring, thoughtful and respectful. We spoke with staff who knew how to maintain people’s privacy and dignity.

People who used the service and their relatives were aware of the registered provider’s complaints procedure. Some people told us that they had raised concerns and that they had been taken seriously and addressed swiftly.

Prior to people using the service, a member of the management team visited people to complete an initial assessment. This information formed the care plan. We looked at people’s care records and found t

As part of this inspection we visited people in their homes and also spoke with people on the phone. People told us that the care staff were very good and they were well looked after. One person we spoke with told us, “The service is brilliant, I called this morning as I needed an earlier call and the staff were with me within five minutes.”

People also told us that staff treated them with respect, listened to them, gave them choices, made them feel safe and supported them. One person we spoke with said, “The staff are excellent they are very professional and make me feel comfortable.”

We also found systems were in place to reduce the risk and spread of infection.

There was an effective recruitment and selection process in place. Although some information was not available at the time of our visit, this has since been supplied by the provider. Staff received appropriate professional development.

We found people were protected from unsafe or inappropriate care by means of accurate records in relation to the care and treatment provided. People told us they were involved in the development of the care plans and their choices were taken into consideration.

We spoke with four people who received a service and also some relatives. The feedback we got was very positive that the service provided was very good; staff turned up on time and delivered the care in a caring way that was personal, flexible and maintained their dignity and privacy. People also said they were given choices and listened to.

The inspection took place on 13 and 18 August and was announced. The provider was given short notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies. We last inspected the service in October 2013 when it was found to be meeting the regulations we assessed.

Care 4 U Care is a care agency. The service is registered to provide personal care to people in their own homes. At the time of our inspection the service was supporting people with a variety of care needs; including older people, people living with dementia and people with a mental health diagnosis. Care and support was co-ordinated from the office, which was based at Manvers, close to Wath-Upon-Dearne.

There was a registered manager at the time of our inspection. 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. The registered manager was registered at a number of locations and there was a general manager at this service who also had management responsibilities.

We found that people’s needs had been assessed before their care package commenced. Most people who used the service and their relatives that we spoke with told us they had been involved in creating and updating their care plans. The information included in the care records we saw identified people’s individual needs and preferences, as well as any risks associated with their care and the environment they lived in. However, some people’s records did not contain all the required information. The provider had identified this and was in the process of further improving the care records. The registered manager told us they focused on care delivery to ensure people’s needs were met and at times carried out visits to ensure no calls were missed. They acknowledged that because of this, at times documentation and records were not always completed in a timely way.

People received a service that was based on their needs and wishes. We saw changes in their needs were identified to enable their care package to be amended to meet the changes.

People who required assistance taking their medication told us staff administered it a timely way. The staff had been trained to carry out this role. However, we found medication administration records had not always been completed. The provider had identified this and was making improvements at the time of our visit.

People who used the service who we spoke with told us the service was very good, staff were kind caring and always stayed the required time ensuring care needs were met.

We found that staff we spoke with had an understanding of the legal requirements as required under the Mental Capacity Act (2005) Code of Practice. The Mental Capacity Act 2005 sets out how to act to support people who do not have the capacity to make some or all decisions about their care.

There were robust recruitment procedures in place. The provider was recruiting staff at the time of our inspection. They told us they were short staffed as a number of staff had left. However, they said staff were covering to ensure people’s needs were met. People we spoke with told us some call times had changed because staff were covering, but they had been informed of this by the registered manager and knew it was only for a short time, until the staff were recruited.

Staff had received formal supervision and annual appraisals had been completed. These ensured development and training to support staff to fulfil their roles and responsibilities was identified.

Staff told us they felt supported and they could raise any concerns with the general and registered managers, and felt that they were listened to. However, staff told us they would like more staff meetings to help communication.

People who used the service told us they were aware of the complaints procedure and said they would contact the registered manager or care co-ordinators if they had any problems. People said, the office staff are always available and deal with any issues immediately.

People who used the service had opportunity to give feedback by completing questionnaires which were sent out yearly. The provider also asked people’s relatives and other professionals what they thought of the service and used people’s feedback to improve the service.

The provider had a system to monitor the quality of the service provided. However, the audits that were undertaken were not always formally documented to evidence what had been identified, what required attention and who was responsible for ensuring any improvements were implemented.