Cure Healthcare Service Ltd is a domiciliary care agency. It provides personal care to older people; people living with dementia; people who misuse drugs and alcohol; people with physical disabilities; learning disabilities and sensory impairment who live in their own homes. Its service covers the counties of Buckinghamshire and Berkshire. At the time of our visit the service provided personal care to 25 people.

The service had a registered manager. 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 and associated Regulations about how the service is run.

This is our first inspection of the service since the provider registered with us on 13 February 2017.

People and their relatives spoke positively about the caring nature of staff. A person commented, “I have observed the carer is such a caring person. She is patient, kind and keen to please.” This was observed during our home visits.

People received care and support from staff that had a good understanding of their care and support needs. Staff protected their privacy when personal care was carried out and their dignity was also respected. We found staff were respectful of people’s cultural and spiritual needs. People were able to express their views and be actively involved in making decisions about their care.

The service had recruitment processes in place but these were not always robust. We made a recommendation about checking job application forms. People said they felt safe when receiving care and support from staff. Staff knew how to keep people safe from abuse and had attended the relevant training. Medicines were administered by staff whose competencies were assessed and people were kept safe from infection.

People were supported to have maximum choice and control of their lives. However, the service was not always compliant with Mental Capacity Act 2005 and its codes of practice. We made a recommendation about this.

Staff were not always appropriately supervised. We made a recommendation for the service to seek current guidance on staff supervisions and appraisals. Staff worked within the principles of the Equality Act 2010 to make sure people were not discriminated against. People’s nutritional and healthcare needs were met.

Most of people’s initial assessments made sure plans of care were personalised and based on what people said they wanted. In some instances the service failed to discuss people’s preferences for end of life care. We made a recommendation for the service to review best practice in recording end of life preferences and wishes.

People knew how to raise concerns. We found the service responded to complaints appropriately. We have made a recommendation for the service to ensure its complaint’s policy is available to all people. The service made sure information was given to people with disabilities or sensory impairments in a format that met their communication needs.

People and their relatives felt the service was well-led and staff spoke positively about the support they received from management. People were given the opportunity to express their opinions about different aspects of the service.

Quality assurance systems and processes in place were not regularly monitored for their effectiveness. Therefore, the service was not always able to identify where quality and safety was compromised and the risks to people.

We found a breach in the regulations as a result of this inspection. You can see what action we told the provider to take at the back of the full version of the report.