This inspection took place on 16 and 17 January 2019 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people, adults, young people, people with learning and profound disabilities and people at the end of life. Not everyone using FlexiCare & Support 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. At the time of the inspection 12 people were receiving personal care from the service.

There was 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.

At the last inspection November 2017, the service was rated as requires improvement. Following this inspection, improvements had been made and service was no longer rated as requires improvement.

Staff were being recruited safely and there were enough staff to take care of people. Staff were receiving appropriate training and they told us the training was good and relevant to their role. Staff were supported by the registered manager and were receiving formal supervision where they could discuss their ongoing development needs.

People who used the service and their relatives told us staff were helpful, attentive and caring. They told us they were treated with respect and compassion.

Care plans were up to date and detailed what care and support people wanted and needed. Risk assessments were in place and showed what action had been taken to reduce any risks which had been identified. People felt safe with staff and the registered manager knew how to make appropriate referrals to the safeguarding team when necessary.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The service worked in partnership with other agencies including health professionals to help ensure people’s healthcare needs were met. Medicines were managed safely.

Staff knew about people’s dietary needs and preferences.

There was a complaints procedure and people knew how to complain.

Everyone spoke highly of the registered manager they who they said was approachable and supportive. The provider had effective systems in place to monitor the quality of care provided and where issues were identified they acted to make improvements.

We found all the fundamental standards were being met. Further information is in the detailed findings below.

The inspection of Flexi Care and Support took place on 1 November 2017, with follow up telephone calls being made to people who used the service, their relatives and staff on 2 and 3 November 2017. The inspection was announced. The service had been registered with the Care Quality Commission since December 2016 and this was the first inspection of the service.

Flexi Care and Support is a domiciliary care provider, providing personal care and support to people living in their own homes, with a focus on supporting and promoting independence and re-ablement. Services are provided to people with a wide range of needs such as adults with learning difficulties, adults whose behaviour is deemed challenging, people with mental health issues, people living with dementia, people with physical disabilities or with multiple diagnosis. There were 12 people using the service at the time of our inspection.

The service did not have a registered manager in post at the time of our inspection, although the substantive manager, in day to day control, had applied to register and their application was being considered by the Care Quality Commission. Since the inspection took place, the manager has registered with the Care Quality Commission. 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 their family members told us they felt safe. Staff had received safeguarding training in order to keep people safe and staff demonstrated a good understanding of what to do if they were concerned anyone was at risk of abuse or harm. Safe recruitment practices were in place, which meant staff had been recruited safely. Risks had been assessed and reduced where possible.

The registered provider had a system in place to record accidents and incidents. Where an incident had been recorded, appropriate actions had been taken. There was an effective out of hours’ telephone service, which people and staff could use, in case of emergencies.

Staff were trained to manage and administer medicines to people and their competency was regularly assessed. There were some gaps in medication administration records and these required more robust auditing. We have made a recommendation about the management of medicines.

People received effective care and support to meet their needs. People and their relatives felt staff had the necessary skills and training to provide effective care and support. Staff told us they felt supported and we saw staff had received an induction as well as ongoing training, development and supervision.

People were supported to have choice and control of their lives and staff supported people in the least restrictive ways. However, care and support was not always provided in line with the principles of the Mental Capacity Act 2005 and records showed assessments of mental capacity, as required by the Act, were lacking. We have made a recommendation about complying with the requirements of the Mental Capacity Act.

People told us consent was sought prior to care and support being provided and this was evident from the care records we reviewed. However, formal written agreements which the registered provider had devised had not been consistently completed.

People we spoke with told us staff were caring. The staff we spoke with were enthusiastic and were motivated to provide good quality care. People told us staff respected their privacy and dignity. People were encouraged to maintain their independence.

Care and support plans were detailed and personalised, taking into account people’s choices, preferences and diverse needs. People told us they could make their own choices and the service was responsive and flexible to their needs.

Regular audits and qual