The inspection took place on the 24 January 2019 and was announced.

Focus Learning is a domiciliary care agency It provides personal care to adults living in their own houses.

This was Focus Learning’s first inspection. They were providing care to two people at the time of the inspection with one person having received care for eight months, therefore we have gathered enough evidence to rate them.

The service had 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.

Risk assessments were not robust as they did not explain how to mitigate risks people may face in or around their home.

Recruitment was not robust at the service, application forms were not fully completed as they had unexplained gaps in staff employment history and dates staff had worked were not completed. Criminal record checks were not robust as they were from the previous employers and this provider had not carried out their own checks to see if staff were safe to work with vulnerable adults.

People’s needs assessment were brief and contained limited information. Care plans were generic and lacked personalisation. Personal details that staff knew about a person such as preferred name and how they liked to receive personal care was not recorded in the care plan.

The registered manager did not show understanding of the Mental Capacity Act 2005.

Care planning documentation contained a number of blank spaces and was not accurate.

The registered manager had systems in place to monitor the quality of the service but these were not implemented as yet. The registered manager told us they completed random spot checks to ensure care staff arrived on time to deliver care but these were not recorded. The registered manager also informed us they had held a team meeting but this had not been recorded.

All staff knew how to report safeguarding and knew how to whistleblow if the registered manager was not acting on their concerns.

The service was not managing medicines but they had policies and procedures in place to support people to receive them safely.

The risk of infection was minimised as staff followed good hygiene practices and disposed of waste appropriately.

Staff had been trained in food hygiene but did not prepare meals for people at the service.

The name of people’s health professional was recorded in the care planning documentation but their contact details were not provided which meant important information could not be shared with them if needed.

Staff supported people to make their own decisions. Relatives thought their family member was safe with the carers and that the carers came on time for calls.

People were cared for by kind and patient staff who spent time with people to get to know them. People’s privacy and dignity were respected as were people’s individuality. Staff also respected people’s confidentiality.

We found breaches of the regulations relating to safe care and treatment, need for consent, fit and proper persons, person centred care and good governance.

We have made two recommendations one for providing GP contact information and another for incorporating equality and diversity in the care planning process.

You can see what action we told the provider to take at the back of the full version of the report.