Forget Me Not Home Services Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to adults. At the time of this announced inspection of 15 August 2018 there were 55 people who used the personal care service. We gave the service 48 hours’ notice of the inspection to make sure that someone was available in the office to assist us with our inspection.

At our last inspection of 31 July 2017, the service was rated requires improvement overall. The key questions for effective, caring and responsive were rated good and the key questions safe and well-led were rated requires improvement. We had found breaches of Regulations 12 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found improvements had been made and there were no breaches of Regulation. The service is now rated good overall and for all of the five key questions.

There was a registered manager in post, who was also a managing director of the organisation. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Improvements had been made in how the service was led. This included improvements in their governance systems to assess and monitor the service provided to people. The service had a quality assurance system and shortfalls were identified and addressed. As a result, the quality of the service continued to improve.

Improvements had been made in how the service provided people with safe care. Improvements had been made to recruit care workers safely. Improvements had been made in how the care workers completed their medicines administration records and these were checked regularly by senior staff.

Risks to people were managed, including risks from abuse and in their daily lives. There were enough care workers to cover people’s planned care visits. The risks of cross infection were minimised.

People continued to be provided with a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people at the end of their lives, where required. A complaints procedure was in place and complaints were responded to in line with this procedure.

People continued to receive a caring service. People had positive relationships with their care workers. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued.

People continued to receive an effective service. People were supported by care workers who were trained to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Systems were in place to assist people with their dietary needs, where required. People were encouraged to access health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

Further information is in the detailed findings below.

This was an announced inspection that took place between 31 July 2017 and 2 August 2017.

Forget Me Not Homecare provides domiciliary care services to people in their own homes. At the time of the inspection, the service provided care and support to 35 people.

We last inspected Forget Me Not Homecare in March 2015 where we rated the service as ‘good’ in each of the key questions and overall. At this inspection we found concerns in ‘safe’, ‘effective’ and ‘well-led’. This means we had concerns at this inspection that we didn’t have at the last one. We have now rated the service requires improvement overall.

At the time of this inspection 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. The registered manager was also the owner of the company Forget Me Not Care. This person has been referred to as the provider throughout this report.

The provider had a recruitment procedure in place; records did not, however, reflect that this was always followed when staff were recruited.

People felt safe with the care they received from staff. The service had clear procedures to help minimise the risk of abuse and staff were aware of these. All staff completed safeguarding training. Risks to people were assessed and there was guidance for staff about how they should minimise these risks while they were delivering care.

Records relating to the administration of medicines were not always accurately completed. This meant the provider was not always able to demonstrate that people had received their medicines as needed and as prescribed.

Staff received on going training which was relevant to the needs of the people they were supporting

People who used the service, their relatives and the staff thought highly of the provider and the ethos of the company.

People who lacked the capacity to make their own decisions or consent to their own care were not always supported in line with the requirements of the Mental Capacity Act 2005. Where people did not have the capacity to make decisions about their own care an assessment had not been completed to reflect how important decisions about them and their care had been made.

Where needed, people were offered support to eat and drink and to prepare meals and snacks. Staff supported people to make and attend health appointments if requested.

People were involved in planning their care and had regular reviews to gain their opinion on how things were. Staff knew people well and people and their relatives felt that they were treated with dignity and respect.

The service had a clear policy and procedure for managing complaints. People knew how to complain and would do so if necessary. Staff felt supported. Staff felt they were listened to and were given the opportunity to raise any concerns. Staff were knowledgeable about people's background histories, preferences and routines.

There were insufficient systems in place to monitor the quality of the care and service provided. Audits were not taking place in relation to people's care records.

The inspection took place on the 16 and 18 March 2015. This was an announced inspection. The provider was given 24 hours’ notice because the location provides a domiciliary care service.

Forget Me Not Home Services Ltd provides personal care support to people living in their own homes. When we inspected there were 47 people using the domiciliary care 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.

There were systems in place which provided guidance for care workers on how to safeguard the people who used the service from the potential risk of abuse. Care workers understood the various types of abuse and knew who to report any concerns to.

There were procedures and processes in place to ensure the safety of the people who used the service. These included risk assessments which identified how the risks to people were minimised.

Where people required assistance to take their medicines there were arrangements in place to provide this support safely.

There were sufficient numbers of care workers who were trained and supported to meet the needs of the people who used the service. Care workers had good relationships with people who used the service.

Where people required assistance with their dietary needs there were systems in place to provide this support safely. Where care workers had identified concerns in people’s wellbeing there were systems in place to contact health and social care professionals to make sure they received appropriate care and treatment.

People or their representatives, where appropriate, were involved in making decisions about their care and support. People’s care plans had been tailored to the individual and contained information about how they communicated and their ability to make decisions.

A complaints procedure was in place. People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

Care workers understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system and shortfalls were addressed. As a result the quality of the service continued to improve.