This inspection took place on the 28 November 2017 and it was announced.

At the last inspection, on 13 July 2015, the service was rated Good overall with requires improvement in Safe. This was because we found concerns relating to management of people’s medication as it was not always possible to monitor if people were receiving prescribed medication. At this inspection, we found the service remained Good in Effective, Caring, Responsive, Well Led and improvements had been made within the Safe domain.

Fitzpatrick Total Home Care Limited is a small domiciliary care agency, providing personal care support to people in their own homes around the Halstead area.

The service has 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was safe. The provider’s recruitment processes ensured that appropriate checks were carried out before staff commenced employment. There were sufficient numbers of staff on duty to meet the needs of people and keep them safe from potential harm or abuse. People’s health and wellbeing needs were assessed and reviewed to minimise risk to health. The service had a good management and monitoring structure in place for medication.

The service was effective. People were cared for and supported by staff who had received training to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough as to ensure they maintained a balanced diet and referrals to health and social care services was made when required.

The service was caring. Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences. Staff always worked hard to promote people’s independence through encouraging and supporting people to make informed decisions.

The service was responsive. People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were supported to follow their interests and participate in social activities. The service responded to complaints received in a timely manner.

The service was Well Led. The service had systems in place to monitor and provide good care and these were reviewed on a regular basis. The registered manager told us that current systems and processes where being updated and improved.

The inspection took place on 14 July 2015 and was announced.

Fitzpatrick Total Home Care Limited is a small domiciliary care agency, providing personal care support to people in their own homes around the Halstead area. At the time of our visit the service was supporting 59 people.

The service has 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 not always safe because staff did not administer medication in a consistent way.

Risk assessments were carried out and measures put in place to manage and minimise any risk identified.

People received support from a consistent team of staff who were well supported and trained.

Care staff understood the need to obtain consent when providing care.

People were supported with meals and to make choices about the food and drink they received. Staff supported people to maintain good health and access health services when needed.

Assessments had been carried out and care plans were developed which reflected individual’s needs and preferences. People knew how to complain and the service responded well when concerns were raised.

Staff were motivated to provide good quality care. The provider was open and transparent when things went wrong. They made difficult decisions when necessary to ensure the service remained sustainable. Systems were in place to monitor and audit the service and were used to drive improvements.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.