We carried out an announced inspection of the DAC Suffolk service location on 14 and 16 January 2019. We spoke with people using the service, relatives and staff on those visits. We spoke with further service users, relatives and staff the following week by telephone. DAC Suffolk 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.

At the time of our inspection, the service provided personal care to 17 people in their own homes. DAC Suffolk commenced operation in January 2018 and this was the first inspection of the service.

The service did not have 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

We met the current manager who was applying to the CQC to become the registered manager of the service. This was the third manager the service had since commencing operation.

Risks to people had not always been robustly managed. This had resulted in the Local Authority suspending the service from providing a service to new people. The service agreed to stop providing a service to some people while it reviewed its capabilities to provide a sustainable and safe service. The current manager had reviewed with each person using the service their care needs and arranged for sufficient staff to attend their care visits.

We found people’s care plans did contain suitable and sufficient risk assessments to inform staff how to effectively manage risks.

Staff had been trained in how to safeguard people.

Full pre-employment checks had been carried out to ensure staff were suitable and of good character to support people in a safe way.

People using the service and their relatives informed us they were encouraged by the care reviews and thorough assessments carried out by the new manager. They were confident the service could meet their needs as sufficient time had been taken to assess people properly.

Staff had been trained to manage medicines safely. There were no gaps in the people’s medicine records we saw which had been checked for accuracy by the manager.

Regular staff supervisions had not been carried out but staff informed us that the new manager was approachable and supportive. Supervision and appraisal sessions were being planned. Training was provided to the staff to inform them how to meet people’s individual needs.

Spot checks of staff supporting people had not been carried out to observe staff performance.

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.

The care plans had been reviewed by the manager and recorded the support people required. Daily notes had been written to confirm people had received person centred care.

People’s privacy and dignity were respected by staff. People and relatives told us that staff were caring and they had a good relationship with them.

A complaints policy was in place to manage complaints. Staff were aware of how to support people with complaints.

Effective quality assurance systems had not been in place throughout the time the service had been in operation. Audits had not identified the shortfalls in the service and hence action not being taken to resolve matters. The new manager had introduced additional auditing of the service which had begun to take effect in improving the service.

A new monitoring system was being introduced so that the manager could be assured that staff were attending call visits. The service did not provide time specific calls unless required due to their assessed needs. However, pe