This announced inspection took place on 20, 28, November and 5 December 2018. This was the first rating of the service since registering with us in December 2017.

Carewatch Redcar and Cleveland is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of inspection, there were 88 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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 not present and was in the process of deregistering and a replacement manager was in post at the service during our inspection and had begun registering with us.

Medicines were not always, recorded or managed safely. We found issues with the records and auditing of medicines. Staff training regarding medicines was not up to date.

A programme of audits were carried out by the manager. However, these were not always effective as we found issues with medicines that were not identified in audits.

Communication systems were in place for staff and team meetings. However, these were not recorded. We made a recommendation to keep records of outcomes following staff meetings.

Accidents and incidents were recorded in various places however, there were no robust monitoring or recording systems in place to monitor accidents and incidents.

Feedback from people regarding the management of the service was mixed however feedback from staff was positive and they felt supported.

People’s nutrition and hydration needs were met and they were supported to maintain a healthy diet. Where needed, records to support this were detailed.

Partnership working was in place with other professionals, including health care professionals and community nurses. Specialist consultants were involved in people’s care, as and when this was needed.

People’s personal risks had been identified and more detailed risk assessments had been written to give staff the necessary guidance on how to keep people safe.

Staff training reflected people’s needs. Staff gave us positive feedback about their training.

People were supported by sufficient numbers of staff to meet their needs. Rotas’ showed there were consistent numbers of staff to meet people’s needs.

People were supported to access information in a variety of formats and adaptations could be made to suit individual needs.

People were supported by kind and caring staff. The feedback from people and their relatives was positive about the staff attitude and their caring nature.

Staff were employed safely and pre-employment checks were carried out on staff before they began working in the service. Staff were supported through an induction period. They received training and supervision from the manager together with an annual appraisal.

People were supported to maintain their independence by staff who understood and valued the importance of this.

Care plans were person centred regarding people’s preferences and were personalised. Person centred means that a person’s preferences are respected and valued when planning and delivering their care and support.

People could complain if they wished to and procedures were in place to support this.

No-one was receiving end of life are at the time of our inspection however, arrangements were in place for people.

People were supported to have maximum choice and control of their lives and staff supported them in their own homes in the least restrictive way possible; the policies and systems in the service supported this practice.

Notifications of significant events were submitted to us in a timely manner by the manager.

We found two breaches of The Health and