Say when the inspection took place and whether the inspection was announced or unannounced. Where relevant, describe any breaches of legal requirements at your last inspection, and if so whether improvements have been made to meet the relevant requirement(s).

Improvement action plan issued following the previous inspection

Where we asked the provider to complete an improvement action plan following the last inspection, include the text below, adapting where necessary:

'Following the last inspection, what they would do and by when to improve the key question(s) to at least good.' Then describe at a high level what you found, adding detail in the detailed findings section for the relevant key question(s).

Focused inspection

'We undertook an announced / unannounced focused inspection of on . This inspection was done to check that improvements to meet legal requirements planned by the provider after our inspection had been made. The team inspected the service against of the five questions we ask about services: is the service well led, , (more as needed)? This is because the service was not meeting some legal requirements.

No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection'

Comprehensive or focused inspection

Where breach topic has moved to a different key question in Next Phase

When we completed our previous inspection on DD/MM/YYYY we found concerns relating to . At this time this/these topic area(s) was/were included under the key question of . We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework this/these topic area(s) are included under the key question of . Therefore, for this inspection, we have inspected this key question and also the previous key question of to make sure all areas are inspected to validate the ratings.

Provide a brief overview of the service (e.g. Type of care provided, size, facilities, number of people using it, whether there is or should be a registered manager etc).

Service Types and descriptions

Care at Home services

Domiciliary care agency

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community [and specialist housing]. It provides a service to [older adults], [younger disabled adults], [children].

Provider of care to people living in specialist housing

Location proving care to people housed under supported living arrangements

This service provides care and support to people living in [a] [insert number of] 'supported living' setting[s], 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.

Location proving care to people living in extra care housing

This service provides care [and support] to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is [bought] [or] [rented], and is the occupant’s own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at peop

This announced inspection took place over three days on 18, 19 and 20 October 2016. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and support to people living in their own homes and we wanted to make sure staff would be available to talk with us about the service. This was a first ratings inspection for the service since it was registered in February 2015.

Everlasting Healthcare Limited was registered in February 2015 to provide personal care and support for adults in their own homes. The service is currently small providing home care support locally. At the time of our inspection the service provided care and support to seven people.

The service is required to have a registered manager in post. 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. A registered manager was in post at the time of our inspection.

The service was not always consistently safe because some of the risk associated with people’s care needs had not at all times been assessed or recorded effectively. Whilst people were included in the planning and review of their care; their care plans and risk assessments did not always reflect their individual needs to ensure they received person-centred care. People felt safe and staff were aware of what would constitute abuse and knew how and who to report it to. The provider had processes and systems in place that kept people safe and protected them from the risk of abuse.

The provider's recruitment processes ensured staff were safely recruited. People felt staff had the skills and knowledge to care and support them in their homes. Staff completed a training induction programme and received on-going training that ensured they had the knowledge and skills to enable them to care for people in a way that met people’s individual needs and preferences. Where appropriate, people were supported to access health and social care professionals.

People were supported to make choices and were involved in the care and support they received. People's rights were protected because staff, including the registered manager understood their responsibilities related to the Mental Capacity Act 2005 and the associated Deprivation of

Liberty Safeguards. The provider knew what appropriate action should be taken to protect people’s legal rights.

Staff was caring and treated people with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s support needs. People, relatives and staff felt they could speak with the provider about their worries or concerns and felt they would be listened to and were confident the provider would take appropriate action where required.

Systems in place to assess and monitor the quality of the service provided to people were not always used effectively to identify or manage risks. The planning and scheduling of visits required some improvement as people who used the service regularly experienced late calls.