The inspection was announced and took place on 11 September 2017. We have not inspected Caremark Norwich since a change in their registration, (legal entity) in July 2016. New services are assessed to check they are likely to be safe, effective, caring, responsive and well-led. As such, they had not yet received a CQC rating.

Caremark Norwich is a domiciliary care agency which provides personal care to people with a variety of needs including older people, people living with dementia, younger adults, people with a learning disability and/or physical disability. The agency's office is located in Norwich. At the time of our inspection, the service was providing personal care to 77 people.

A newly appointed manager was in post, who had recently registered with Care Quality Commission in August 2017. 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 received mixed feedback regarding people receiving calls at their preferred time and how the office communicated with people and their relatives about this and when changes were made to rotas. We discussed this with the provider and registered manager who offered explanations as to why this had been highlighted. We have discussed these issues within the Well-Led section of this report and recommended the provider reviews how they communicate with people and their relatives about what they are able to provide, regarding times of care calls and when changes are made to allocated staff.

People and healthcare assistants spoke highly of the care co-ordinators and the company. People expressed satisfaction with the service they received. However, we found that quality assurance systems were not always being used to ensure accurate records were maintained and to drive improvements. We identified there was a delay in daily notes and medication administration records (MAR) being delivered to the office from people's homes which could delay timely quality monitoring of those records. The provider updated their audit tool on the day of inspection to improve this; however we will need to assess how this improvement has been embedded and sustained at our next inspection. We found no evidence that the lack of audits and gaps in records had affected the quality of service people received.

Risks to people's wellbeing and safety had been effectively mitigated. We found individual risks had been assessed and recorded in people's care plans. Examples of risk assessments relating to personal care included moving and handling, nutrition, falls and continence support. Health care needs were met well, with prompt referrals made when necessary.

People told us they felt safe receiving the care and support provided by the service. Staff understood and knew the signs of potential abuse and knew what to do if they needed to raise a safeguarding concern. Training schedules confirmed staff had received training in safeguarding adults at risk.

Robust recruitment and selection procedures were in place and appropriate checks had been made before staff began work at the service. This contributed to protecting people from the employment of staff who were not suitable to work in care. There were enough staff to protect people's health, safety and welfare in a consistent and reliable way.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed safely.

The management team and staff had an understanding of the Mental Capacity Act 2005 and consent to care and treatment.

People chose their own food and drink and were supported to maintain a balanced diet where this was required.

People said staff were caring and kind and their individual needs we