This inspection took place on 5 November and 16 November 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people, adults, young people, people with learning and profound disabilities and people at the end of life. Not everyone using Care2Care (Yorkshire) Ltd 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 the inspection 29 people were receiving personal care from the service.

At the last inspection in August 2017, the service was rated requires improvement. There were breaches in Regulation 17 good governance and Regulation 19 fit and proper persons employed. At this inspection we found some improvements, however, the service was still in breach of Regulation 17.

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 told us they felt safe. Staff knew how to recognise and report any concerns about people's safety and welfare. Risks to people’s health and safety were not always assessed to help protect people from harm.

We found medicines were not always managed in a safe or proper way. We found discrepancies with medicine administration records (MARs).

There were enough staff deployed to ensure people received care. Safe recruitment procedures were followed to help ensure staff were of suitable character to work with vulnerable people.

Staff did not always receive appropriate training. However, they told us the training they had received was good and relevant to their role. Staff were supported by the manager and were receiving formal supervision where they could discuss their ongoing development needs.

People who used the service and their relatives told us staff were helpful, attentive and caring. We saw people were treated with respect and compassion.

Care records did not always contain sufficient detail for staff to know what support to offer people. People felt they participated in planning their care. Care records included information about people’s preferences, likes and dislikes.

The service worked in partnership with other agencies including health professionals to help ensure people’s healthcare needs were met.

Staff knew about people’s dietary needs and preferences. People told us their choice of meals was followed.

A complaints procedure was in place, which enabled people to raise any concerns or complaints about the care, or support they received. However, the service did not always record complaints in a consistent way.

People using the service, relatives and staff we spoke with were positive about the management team. Staff said the registered manager was approachable and supportive.

We found the provider’s quality monitoring systems were not always working as well as they should be. Some of the concerns we found at our inspection should have been identified through a robust system of checks.

We found three breaches of regulations in relation to safe care and treatment, good governance and staffing training. We are considering the appropriate regulatory response to our findings.

Care2Care (Yorkshire) Limited is registered as a domiciliary care agency and provides a range of services including personal care to people living in Bradford West Yorkshire. The service also provides a night roaming service and a night sitting service to enable people to remain in their own home. At the time of inspection the agency was providing care and support to 23 people.

We inspected Care2Care (Yorkshire) Limited on the 8, 23 and 25 August 2017. We announced the first day of inspection 48 hours prior to our arrival to make sure the registered manager would be available. This was the first inspection of the service since registration in February 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.

We found staff received training to protect people from harm and they were knowledgeable about reporting any suspected abuse. Including the registered manager and other senior staff members there were sufficient number of staff employed for operational purposes. However, the registered manager confirmed additional staff were required to meet demand and before the service could take on new contracts.

There was a staff recruitment and selection procedure in place designed to ensure only people suitable to work in the caring profession were employed. However, we found this was not always being followed correctly.

Where risks to people’s health, safety and welfare had been identified appropriate risk assessments were in place, which showed the action taken to mitigate those risks.

The people we spoke with and their relatives told us the service was generally reliable and staff usually arrived around the same time each day and stayed for the correct amount of time.

The staff we spoke with were able to describe how individual people preferred their care and support to be delivered and the importance of treating people with respect in their own homes.

Staff told us the agency provided good training opportunities. However, we found the training matrix was not up to date therefore the agency was not able to evidence the training being provided.

The registered manager demonstrated a good understanding of their responsibilities under the Mental Capacity Act 2005 (MCA) and staff demonstrated good knowledge of the people they supported and their capacity to make decisions.

The support plans we looked at were person centred and were reviewed on a regular basis to make sure they provided accurate and up to date information. The staff we spoke with told us they used the support plans as working documents and they provided sufficient information to enable them to carry out their role.

If people required staff to assist or support them to prepare food and drink information was present within their support plan and staff told us they encouraged people to eat a healthy diet.

Staff ensured people had access to a GP and other healthcare professionals when they needed medical attention and people told us they had contact details for the agency which they could use out of normal office hours in case of emergency.

Procedures were in place to ensure people received their medicines as prescribed. However, we found staff were not always completing the medication administration records [MAR] correctly and this had not been identified through the internal audit system.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. People told us they felt able to raise any concerns with the registered manager and felt these would be listened to and responded to effectively and in a timely manner. However, we found not all formal complaints