Chinite Resourcing Limited is a domiciliary care agency, which provides personal care and support to people in their own homes, from daily visits to 24 hour live in care. At the time of the inspection there were 15 people using the service.

We carried out an announced comprehensive inspection of this service on 17, 18, 21 November 2016. The provider was given 48 hours' notice of our visit because they provide a domiciliary care service and we needed to be sure staff would be available at the location to meet with us.

We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were:

Regulation 9 Regulated Activities Regulations 2014 - Person centred care

Regulation 11 Regulated Activities Regulations 2014 - Dignity and respect

Regulation 12 Regulated Activities Regulations 2014 - Safe care and treatment

Regulation 16 Regulated Activities Regulations 2014 - Complaints

Regulation 17 Regulated Activities Regulations 2014 - Good governance

Regulation 18 Regulated Activities Regulations 2014 - Staffing

Regulation 19 Regulated Activities Regulations 2014 – Fit and proper persons

Regulation 18 Registration Regulations 2009 – Notification of other incidents

The overall rating for this service was 'Inadequate' and the service was therefore placed in 'Special Measures'. Services in special measures are kept under review and, if we have not taken immediate action to propose to cancel the registered provider's registration of the service, we will inspect them again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

We took enforcement action and served a Notice of Decision putting conditions on their registration which told them they must not take on any more people to provide care for and must not agree to increase the level of personal care being provided to current people using the service, without our written agreement. Additional conditions placed on them were that they report to us about how they recruited staff, arranged the staff rotas, checked the competency of the staff and how their quality assurance systems checked that care plans and risk assessments reflected the needs of the people who used the service.

We sent an urgent action letter requesting information and an action plan. We gave the provider until 24 November 2016 to ensure they complied with the Notice of Decision. The provider sent us a comprehensive plan with the actions they intended to take.

At this inspection in May 2017, we found the service had made significant improvements and that all the breaches of the regulations found in our visit in November 2016 had now been met. The provider had also met the conditions which we had imposed on them and had embraced the opportunity to learn from the mistakes made and embed the necessary improvements. In order for these improvements to be sustainable in the longer term, we have proposed to keep two of the conditions, (staff rota arrangements and quality assurance), in place which we will review at a later date.

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.

The registered manager had revised the risk assessments and care plans to ensure they were aware of how to support people to remain safe in their homes and to be as independent as possible.

There were sufficient staff to meet people’s needs and to manage risk safely. Improvements had been made to the checks carried out on new staff to ensure recruitment was robust and safe.

The registered manager and staff had taken steps to ensure th

Chinite resourcing is a domiciliary care agency, which provides personal care and support to people in their own homes, from daily visits to 24 hour live in care. At the time of the inspection there were 19 people using the service. Chinite resourcing also acts as a recruitment agency supplying staff to care homes. This aspect of their business is not regulated by CQC.

This comprehensive rating inspection took place over three days on the 17, 18 and 21 November 2016, our visit on the 17 November 2016 was announced. The provider was given 48 hours' notice of our visit because the location provides a domiciliary care service and we needed to be sure staff would be available to meet with us.

During this comprehensive inspection we found multiple breaches of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special Measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the registered provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of Inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the registered provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. This will lead to cancelling their registration or to varying the terms of their registration.

The company had a registered manager and a nominated individual in this 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. An organisation needs to have a nominated person who acts as the main point of contact for us. They must also be employed as a director, manager or secretary of the organisation, so that they have the authority to speak on behalf of the organisation. The registered manager was not in the country when we visited; an acting manager had been appointed but had only been in post for four weeks. Prior and during this inspection the acting manager had identified many of the concerns we found but had not had sufficient time to make improvements. The acting manager had also recruited a compliance manager and a care co-ordinator.

Risk assessments and risk management plans did not provide staff with clear guidance about how to safely manage known risks to people. They were not always up to date, which meant they did not reflect people's current needs.

Medicines were not managed consistently and safely. Safe medicine administration practices were not followed so people were not protected against the risks of unsafe management of medicines. Out of 22 staff files checked, 15 did not have up to date training in managing medicines or any checks to assess that they had the required competency to manage medicines safely.

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Staff could not identify the signs that someone may be being abused. The service did not have clear systems in place to report and investigate abuse and incidents were not always referred to the appropriate agencies. Action was not taken where