This inspection took place on the 7 December 2017 and was announced. At the previous inspection of this service in July 2016 we found three breaches of regulations. Staff were not always punctual, the service had not always notified the Care Quality Commission (CQC) of allegations of abuse and quality assurance systems were not being properly implemented. We found these issues had been addressed during this inspection.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe and well-led to at least good. The action plan set out the action they planned to take and during the inspection we found it had been taken and issues had been addressed.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and younger disabled adults. 117 people were using the service at the time of our inspection.

The service had a registered manager in place. 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.

Appropriate safeguarding procedures were in place and people told us they felt safe using the service. Risk assessments provided information about how to support people in a safe manner. There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Medicines were managed safely. Staff had a good understanding about infection control issues and used protective clothing to help prevent the spread of infection. Lessons were learnt when accidents or incidents occurred to help improve the service.

People’s needs were assessed before they began using the service. Staff received training and supervision to support them, in their role. Where the service supported people with meal preparation they were able to choose what they ate and drank. People were supported to access relevant health care professionals and the service worked with other agencies to support people. People were able to make choices for themselves where they had the capacity to do so and the service operated in line the Mental Capacity Act 2005.

People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.

Care plans were in place which set out how to meet people’s individual needs and these were subject to review. The service had a complaints procedure in place and people knew how to make a complaint.

Staff and people spoke positively about the registered manager. The service had various quality assurance and monitoring systems in place, which included seeking the views of people on the running of the service.

The inspection took place on the 7 and 8 of July and was announced

Caronne Care Ltd is a domiciliary care agency providing support to people in their own home. At the time of the inspection there were 37 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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.

People who used the service told us their carers were often late and this meant they had to wait for personal care or their medicines putting people at risk of unsafe care.

People felt safe with their carer and said they always introduced where they were from when they attended their home. Relatives told us they felt they had been given peace of mind as the carers kept they family member safe.

People received their medicines in a safe way and staff demonstrated they knew how to administer medicines safely. Staff were supported in this area with regular training and competency tests in medicines.

The service carried out recruitment safely and ensured pre-employment checks were completed before staff started to work in the community on their own.

Risk was assessed and records showed that the service performed detailed assessments of people’s home environment and equipment used to keep people safe and if necessary to request a an assessment for further equipment to protect people in their home for example a commode to support going to the toilet safely.

Staff received regular supervision in one to one sessions and in a group setting. Staff had commented that one to ones were sometimes not always in private. We have made a recommendation in this area.

The registered manager told us that staff had commenced the care certificate and records showed some staff had completed this training which they said was very helpful for their role.

Staff demonstrated a good understanding of the Mental Capacity Act 2005 and gave examples of how they supported people to make their own decisions when delivering care and when an assessment would be needed to assess capacity.

People and their relatives told us that the registered manager and staff were caring. People said the staff were very kind and lovely. Staff told us they would sit and talk with people and engage with them even for an extra five minutes after their shift has finished as they may not see anyone else.

People were involved in their care asked about their preferences and how they would like to receive care so that care was personalised to their needs. Consent was requested before care was given and when personal care and medicines were to be administered. Staff told us they did not force people to do anything they did not want to do.

People had support plans which were reviewed regularly with the registered manager and their relative. Records showed that the service was responsive to people’s needs and acted when they observed deterioration in people’s care needs or when they improved. Records showed that the registered manager had updated people’s care plan when they had become more independent to feed themselves.

People knew how to make a complaint about the service and records showed that they were recorded in line with the complaints policy. Records confirmed that the registered manager called people back promptly.

Notifications concerning safeguarding had not been sent to the CQC, the registered manager had notified the local authority. However they had not informed the CQC as required by the regulations.

Quality assurance at the service was not always robust. The registered manager showed us auditing tools they had to check medicines and daily logs that staff completed but they were not being consistently completed as there were blank forms. The registered mana