This inspection took place on the 19 February 2018 and was announced. At the previous inspection of this service on 1 June 2016 we found two breaches of regulations. This was because care plans were not sufficiently detailed and quality assurance and monitoring systems were not effective.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of responsive and well-led to at least good. We found the service had taken appropriate action to achieve this and breaches of regulations ad been addressed.

This service 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 younger disabled adults. One person was using the service at the time of our inspection.

The service had a registered manager in place. 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.

Appropriate safeguarding procedures were in place. Risk assessments provided information about how to support people in a safe manner. Staff had a good understanding about infection control issues and used protective clothing to help prevent the spread of infection. Lessons were learnt when accidents or incidents occurred to help improve the service. Robust staff recruitment practices were in place and there were enough staff to meet people’s needs.

People’s needs were assessed before they began using the service. Staff received training and supervision to support them in their role. People were able to make choices for themselves where they had the capacity to do so and the service operated in line the Mental Capacity Act 2005.

Staff had a good understanding of how to promote people’s privacy, independence and dignity.

Care plans were in place which set out how to meet people’s individual needs and these were subject to review. The service had a complaints procedure and end of life care procedures in place.

Staff spoke positively about the registered manager. The service had systems in place for seeking the views of people on the running of the service and quality assurance systems were operated effectively. Auditing systems were in place to check records.

The inspection took place on the 1 June 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

Firstchoice Consultancy was inspected but not rated as the service was not fully operational. Firstchoice Consultancy had not previously been inspected.

Firstchoice Consultancy is a domiciliary care agency providing personal care to people in their homes. At the time of our inspection they were providing support to one person.

Firstchoice Consultancy had a registered manager in place. 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 as staff knew how to identify abuse and escalate it further. They knew who to approach and had received up to date training. However policies in relation to safeguarding and whistleblowing were not current as they did not provide staff with current information on contacting the regulator Care Quality Commission (CQC) or the Police.

Safe recruitment practices were followed to ensure staff were of good character and able to work with people.

Staff were supported before they went out to work with people and received an induction from the service. Staff received supervision with the registered manager and staff told us they met with the registered manager once a week, these meetings were not recorded.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and gave examples of how people may be able to make some decisions but may have to have their capacity assessed for other decisions. Care plans stated that relatives had power of attorney to make decisions on behalf of people however the type of power of attorney they had was not clear.

Staff were caring and respected people’s privacy and dignity.

The service assessed people’s needs and risks but records indicated they had not been done when people commenced care with the service. People’s care plans recorded most of the support to be given but where people were receiving personal care it was not documented how they received it and the level of support to be provided. Staff were knowledgeable about the care they gave to people and how they did this but records did not state this. Although people’s preferences were recorded in their care plans, records showed care was not delivered according to their preferences.

The service had a registered manager and staff told us they were able to contact them when they needed to. The registered manager sought the feedback of relatives and staff and records confirmed this had been done. The registered manager did not have an effective quality assurance process to check the quality of records and that information was correct and up to date.

We found two breaches of the regulations. You can see what action we told the provider to take at the back of the full version of the report.