This inspection was completed on 27 September 2018 and 1 October 2018 and was announced. The provider was given 48 hours’ notice of the inspection because the service provided was domiciliary care in people’s own homes and we wanted to make arrangements to contact people.

Fabeliz is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. Not everyone using Fabeliz receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. There were eight people receiving the regulated activity of ‘personal care’ from Fabeliz at the time of the inspection.

There was a registered manager in post at the service. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The previous inspection was completed in July 2017 and the service was rated ‘Requires Improvement’ overall. We did not find any breaches of regulation but identified some areas for improvement. Systems to support people with their medicines were not always clear. W Medicine records did not have sufficient information for staff to administer the medicines safely and where risks to people’s personal safety had been identified written plans were not in place to minimise these risks. The service did not have formal auditing systems to monitor the quality of the service.

At this inspection, we found improvements had been made and the service has been rated ‘Good’ overall.

People received safe care and treatment. Staff had been trained in safeguarding and had a good understanding of safeguarding policies and procedures. The administration and management of medicines was safe. There were sufficient numbers of staff working at the service to meet people’s needs. There was a robust recruitment process to ensure suitable staff were recruited.

Risk assessments were updated to ensure people were supported in a safe manner and risks were minimised. Where people had suffered an accident, themes and trends had been analysed, and action had been taken to ensure people were safe. Plans had been put in place to minimise the risk of re-occurrence.

Staff had received training appropriate to their role. People were supported to access health professionals when required. They could choose what they liked to eat and drink and were supported on a regular basis to participate in meaningful activities.

People were supported in an individualised way that encouraged them to be as independent as possible. People were given information about the service in ways they wanted and could understand.

People and their relatives were positive about the care and support they received. They told us staff were caring and kind and they felt safe living in the home. We observed staff supporting people in a caring and patient way. Staff knew people they supported well and could describe what they liked to do and how they liked to be supported.

The service was responsive to people’s needs. Care plans were person centred to guide staff to provide consistent, high quality care and support. Daily records were detailed and provided evidence of person centred care. Where required, people were supported to make decisions about end of life care, which met their individual needs and preferences.

The service was well led. People, staff and relatives spoke positively about the registered manager. Quality assurance checks were in place and identified actions to improve the service. Where issues had been identified, appropriate action had been taken to

Fabeliz is a domiciliary care service providing personal care and support to people living in their own homes in the Marlborough and surrounding towns and remote villages. At the time of our inspection, six people were using the service.

This was the service’s first rated inspection since they registered with the CQC in February 2016.

This inspection took place on 14 June 2017. This was an announced inspection which meant the Provider was given notice before we visited. This was because the location provides a home care service. We wanted to make sure the registered manager, or someone who could act on their behalf, would be available to support our inspection.

The service had 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.

People and relatives spoke highly of the care they received and all said they would recommend Fabeliz to others. They told us staff were kind and caring in their approach and they felt comfortable with staff. Comments included “I am very satisfied”, “Carers are always amenable and flexible enough”, “They are extremely helpful” and “Yes, they are caring. I think very highly of them”.

People received care and support from staff who had got to know them well. The relationships between staff and people receiving support demonstrated dignity and respect at all times.

Systems to support people with their medicines were not always clear. Since our inspection the registered manager had implemented a new system to ensure the safe administering of medicines.

Risks to people’s personal safety had been assessed, however we found where risks had been identified, plans were not in place to minimise these risks. For example where it was identified a person was at risk of falls, an associated risk assessment on how to minimise the risk was not in place. Since our inspection the registered manager had devised an additional risk assessment to include more detailed information where a risk had been identified.

The service asked for people’s consent to care and support in their own homes, before commencing the care. Staff understood the importance of giving people choice and supporting decision making.

People and their relatives spoke positively about staff and told us they were skilled to meet their needs.

People and their relatives told us they felt safe when carers visited them in their homes to provide support. Comments included “Yes, definitely feels safe”, “Very much so” and “Yes, I do feel safe”.

Staff had the knowledge and confidence to identify safeguarding concerns and act on them to protect people.

The service was responsive to people’s needs and wishes. People said they had no complaints about the service they received, however they knew who to contact if they did have a complaint.

Staff told us they felt supported by the registered manager. The registered manager was accessible and any concerns raised would be dealt with immediately.

People and their relatives’ feedback were encouraged through six monthly surveys and care reviews. However, we found there were no auditing systems in place to assure the quality and safety of the service.