Concord House is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger adults with a disability. At the time of our inspection 32 people was receiving personal care as part of their care package.

This is the provider’s first inspection since registration.

The service had a registered manager at the time of our inspection visit. 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.

People did not consistently receive safe support in the management of their medicines. People’s medicine administration records, did not provide sufficient assurances that people had received their prescribed medicines safely. National best practice guidance in the management of medicines were not fully followed.

Risks associated with people’s needs were not consistently assessed, staff therefore did not always have the required guidance to manage and reduce risks. There was no formal process to review accidents and incidents, this therefore impacted on the provider having clear oversight of any trends and patterns developing.

There were sufficient staff to meet the current care needs of people and recruitment checks were completed, to inform safe recruitment decisions. Safeguarding procedures were in place to inform staff of how to recognise and report safeguarding concerns. Safeguarding refresher training for staff was overdue, but action was being taken to address this by the management team.

Staff followed best practice guidance in relation to the prevention and control of risks associated with cross contamination.

The assessment of people’s needs did not fully consider the protected characteristics under the Equality Act. This was a concern because people may have been exposed to discrimination. Staff had received an induction, refresher training was overdue, but the management team were aware of this and were taking action to address this. Staff had not received supervision and appraisal meetings at the frequency the provider expected.

People were supported with any needs identified with eating and drinking. People’s health needs were monitored and staff supported people where required if they were unwell.

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

People were involved in planning and reviewing their care. However, reviews were not completed at the frequency the provider expected or routinely, when changes occurred. People were supported by staff in ways which promoted and respected their dignity and independence. Information about an independent advocacy service had not been made at the time of this inspection, but the management team agreed to source this information and make available to people.

People’s care plans were not consistently detailed to provide staff with guidance to meet their individual needs. However, people were positive and complimentary about how their care needs were met. The accessible information standard had been considered by the provider. The complaints procedure had been made available. At the time of this inspection end of life care was not provided.

During this inspection, we found two breaches of the of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.