The inspection took place on 15 September 2016 and was announced. We gave the provider 48 hours’ notice of our visit because we wanted to make sure someone would be in the office to talk with us.

East Midlands Homecare Limited is a home care agency supporting people who live in their own homes. At the time of our inspection 39 people used the service.

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 were protected from abuse because staff had received training and knew how to recognise the signs of abuse. Staff knew the correct action to take if they suspected abuse. This included contacting other authorities such as the local authority safeguarding team or the police. Risk was assessed and staff knew how to provide care and support in the safest way. People were able to take informed risks and had their freedom supported and respected.

Staff were deployed in sufficient numbers to meet people's needs. People were supported with their medicines in a safe way. Staff had received training and had their competency assessed.

Staff had the skills and knowledge to ensure people received the care and support they required and in the way they preferred. Staff were supported and systems were in place to check they were working in line with the providers policies and procedures. People were supported to maintain good health and had assistance to access health care services when needed. People were asked for their consent and were encouraged to make decisions and choices.

Staff worked in a flexible way so that people's changing needs could be accommodated. Additional care and support was provided when required and people spoke highly about the staff and said they were kind and protected their privacy and dignity. People were involved in developing their care plans and asked for their feedback on a regular basis. Systems were in place to monitor the quality of the service. People knew how to make a complaint should they need to and were confident that staff would take action

People told us that they were involved in making decisions about their care and support and understand what choices are available to them. One person told us "I've been involved from day one. A lady visited me before I started using them so we could discuss what I needed. This was put in place and I get regular visits to check that my support is as we agreed".

People we spoke with were happy with the service delivered by the provider. People said that the care workers provided the support and assistance they needed. One person told us "I can't fault them. The staff are very, very good and friendly. They help me out no end".

We saw that the provider managed people's medication effectively and administered it appropriately when people required assistance. The provider carried out medication risk assessments and completed medication paperwork to show that people received medication when they needed it.

The provider had appropriate recruitment practices in place and we saw that people received necessary checks prior to beginning work.

We saw that the provider had a number of quality assurance and audit processes in place which enabled them to monitor and improve the service they provided.

We found that the provider had implemented a more robust process when filing records within care plans. We also found that the provider was carrying out audits to ensure that the care plan contents were accurate and up to date.

People told us that they received the required support and assistance from the care workers. One person told us that the care workers "do everything they need to for me and everything I ask them to". The care workers employed by the provider received appropriate training and support to deliver care to people using services. One care worker told us "I feel supported by the office". The provider had systems in place to quality assure the care that people were given and used the information obtained to put action plans in place for future development. However we found that the provider's records were not being managed in a secure, accurate and accessible manner.