The inspection took place on 20 and 24 September 2018 and was announced. We gave the service 48 hours' notice of the inspection visit because we wanted to give the provider enough time to prepare information we needed as part of our inspection process. This would ensure the registered manager would be available because the service was small. The inspection was prompted in part by information provided by the local authority about an incident following which a person using the service sustained a serious injury. This incident is subject to a safeguarding investigation by the local authority.

This inspection was carried out to check on how people were being supported due to concerns identified by the local authority about risks to people. The last inspection of this service in September 2015 rated the service as ‘Good’ overall with a ‘Requires Improvement’ in the Safe question.

Dudley and Wolverhampton Domiciliary Care is registered to provide personal care services to people in their own houses and flats in the community and specialist housing. This service is a domiciliary care agency. It provides a service to older adults, younger disabled adults and children.

This service provides care and support to people living in a number of ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

On the day of the inspection there were 26 people receiving support. There was no registered manager in post as they had recently left. 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.

Care staff were trained to recognise risks to people to keep them safe. There were enough care staff to ensure people were supported timely and medicines were administered. Care staff were provided with personal protective equipment to support people in a way that reduce the risks of infection.

Training was provided to care staff so they had the skills and knowledge to meet people’s needs. People made their own decisions as to how they were supported. The provider adhered to the Mental Capacity Act (2005).

Care staff supported people in a friendly and kind manner. People were involved in the assessments and care planning process so they could be supported how they wanted. People were supported respecting their privacy, dignity and independence.

People’s views were listened to in how they were being supported. The provider had a complaints process in place to enable people to raise concerns they may have.

The provider carried out spot checks and audits but these were not effective in ensuring the quality of the service was maintained. Care records did not consistently reflect accurately or clearly people’s support needs.

While people could complete a questionnaire to share their views on the service they received, the provider did not ensure the outcomes and actions from the process was shared with people.

This announced inspection took place on 8,10,11,15 & 17 September 2015. The provider had a short amount of notice that an inspection would take place so we could ensure staff would be available to answer any questions we had and provide the information that we needed.

Dudley and Wolverhampton Domiciliary Care are registered to deliver personal care. They provide Domiciliary care to people living in their own homes and support packages to a number of people who lived in four specially adapted bungalows. People who used the service had a range of support needs related to old age, dementia, mental health, learning and/or physical disabilities. At the time of our inspection 23 people received personal care from the provider.

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 2008 and associated Regulations about how the service is run.’

People and their relatives told us they felt confident that the service provided to them was safe and protected them from harm. We found overall that medicines were managed and monitored effectively within the service. Guidance for staff in relation to medicines to be given directly into the stomach were lacking.

Assessments had been undertaken to identify the issues that may put people using the agency at risk. People and their relatives told us they received the care they needed, when they needed it.

There were a suitable amount of staff available to deploy who had the skills, experience and training in order to support people and meet their needs.

Staff had access to a range of training to provide them with the level of skills and knowledge to deliver care safely and efficiently. The registered manager was responsive in sourcing specific training for staff when it was needed.

Care plans contained information about people’s abilities, preferences and support needs. People and their relatives told us staff established consent before providing care.

People and relatives told us that staff acted in a way that maintained people’s privacy and dignity whilst encouraging them to remain as independent as possible. People were supported to take food and drinks in sufficient quantities to prevent malnutrition and dehydration.

Systems were in place for people and their relatives to raise any concerns they had or to make a complaint.

Structures for supervision allowing staff to understand their roles and responsibilities were in place.

Staff told us the registered manager actively promoted an open culture amongst them and made information available to them to raise concerns or whistle blow.

The agency sought people’s feedback through questionnaires and phone contacts about the quality of the service. The registered manager and the provider undertook regular checks on the quality and safety of the service.