This comprehensive inspection took place on the 11 and 13 September 2018 and was announced. This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to adults. At the time of our inspection the provider was supporting 54 people.

At our last inspection the provider was rated as requires improvements and were in breach of regulations. At this inspection the provider has improved to good.

There is 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 were safe and risks, including environmental had been considered and reviewed. There were systems in place to ensure medicines were managed in a safe way. There were enough staff available to support people and the provider had ensured they had received an induction and relevant training. Staff understood when people may be at risk of harm and there were procedures in place for this. We found there were also infection control procedure in place and these were followed including the use of gloves and aprons whilst supporting people.

People were supported consistently in a kind and caring way by staff they were happy with. People’s independence was promoted and they were encouraged to make choices. We found people’s privacy and dignity was promoted. There was a complaints procedure in place and this was followed when needed, when complaints had been made these had been responded to in line with this procedure and people were happy with the outcome.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. We found when needed there were capacity and best interest decisions in place. The service worked jointly with health professionals when needed and people had access to health professionals. When needed people were supported to purse their hobbies and interests and with eating and drinking.

There were systems in place to monitor the quality of the service and this information was used to drive improvements. When things had gone wrong within the service the provider and manager used this information so lessons could be learnt and improvements made. We were being notified of significant events that had occurred and the provider was displaying their rating in line with our requirements. Staff felt supported and listened to people were happy with the care and support they received.

We inspected this service on 18 and 19 July 2017. This was an announced inspection and we telephoned 48 hours’ prior to our inspection in order to arrange home visits with people who use the service. This was the first inspection of the service.

Caremark Cannock Chase and South Staffordshire provides personal care and support to people living in their own homes in Cannock and the surrounding areas. At the time of our visit, 19 people were receiving a service.

There was a registered manager at the service. 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.

There were insufficient staff available to ensure people received timely support. People told us their calls were often late or rushed and staff felt under pressure to work long hours to ensure people’s calls were covered. Staff did not always feel they were listened to and were concerned that staff morale was low due to high staff turnover.

People's medicines were not always managed safely. Staff did not consistently record when they administered medicines. Medicine records had not been reviewed or checked by the management team, so these issues had not been identified. The provider could not evidence staff received a suitable induction and adequate training to support them to fulfil their role.

The provider did not have effective systems to continually assess, monitor and improve the quality and safety of the service. There was a lack of oversight by the provider and registered manager to ensure that people received their planned care. They did not have a system to monitor for missed calls or review people's daily notes so they were unaware of any concerns or changes that needed to be acted on. The provider did not always notify us promptly of important events that occurred in the service.

Staff did not always follow the legal requirements when people lacked the capacity to make certain decisions. Staff understood the importance of consent where people had capacity to make their own decisions.

People had good relationships with the staff and felt safe when they supported them. Risks associated with their care and home environment were assessed and managed. Staff understood their responsibilities to protect people from the risk of abuse and were confident any concerns reported to the registered manager would be acted on. However, some staff were unsure of how to escalate concerns to the local safeguarding team if they needed to. The provider followed recruitment procedures to ensure staff were suitable to work in a caring environment.

People's privacy and dignity was maintained and they were encouraged to be independent and follow their hobbies and interests. People managed their own healthcare needs but staff supported them to access other health professionals if required. Where needed, people were supported to have sufficient amounts to eat and drink.

People felt involved with the planning and reviewing of their care and felt confident raising any concerns or complaints. The provider had started to seek people’s views on the quality of the service and planned to use the information to make improvements.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.