Classique Care Service provides personal care to people in their own homes. People who used the agency included older people with physical and mental health needs including dementia. There were 17 people using the service at the time of this inspection.

This inspection took place on 5 April 2018. We gave two days’ notice to the provider to ensure someone was available to assist us with the inspection. This was our first inspection of the service since they registered with us in August 2016. The service was dormant until August 2018 when they began providing care to people.

The service did not have 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. Two managers had registered with CQC who had both left the service. The director told us they were considering registering as manager and would confirm this as soon as possible.

The provider did not always assess risks to people’s care, such as those relating to moving and handling, as part of doing all they could to reduce the risks. This meant written guidance for staff in reducing risks was lacking for some people.

The provider did not always manage people’s medicines safely as systems were not in place to check people received their medicines as prescribed. The provider had not assessed risks relating to medicines as part of safe medicines management.

People did not always receive care in a timely manner and most people and relatives we spoke with complained about poor timekeeping. The provider was introducing an electronic system to monitor timekeeping to help improve this issue.

People and relatives were not always positive about the staff who supported them. People and relatives fed back issues relating to dignity and respect and supporting people to maintain their independence. Some staff developed good relationships with people by getting to know them, but not all staff understood people’s needs well enough.

The provider did not always use concerns people and relatives raised to improve the service people received. The systems to ensure open communication with people and relatives required improvement. The provider did not have suitable systems to oversee the service to ensure people received a good quality of service.

People did not always receive care in line with the Mental Capacity Act 2005 (MCA). This was because the provider did not always carry out mental capacity assessments when there was reason to suspect a person may lack capacity in relation to their care. This meant the provider did not always follow the MCA in ensuring decisions were made by people themselves if they had capacity or in their best interests if they lacked capacity.

Staff received the support from the provider to understand their roles and responsibilities. The provider trained new staff in key topics during their induction period and ensured they shadowed more experienced staff before caring for people alone. However, training in MCA was not always provided to staff so they understood how to care for people in line with the Act. The provider planned annual training for staff in key topics to keep their knowledge current. Most staff were in their probationary period and were informally monitored as part of this. The provider told us they were establishing systems to review staff performance during their probation more formally and to set up a system of regular staff supervision.

People were not always supported sufficiently to maintain their health as feedback we received from people and relatives in relation to this was not always positive.

Systems were in place to safeguard people from abuse and neglect such as training for staff on their responsibilities. However, some pe