Fosse Healthcare - Newark is a domiciliary care agency. It is registered to provide personal care to people living in their own homes in the community, including older people and people with physical disabilities. The service was registered by the Care Quality Commission (CQC) in June 2017. This was our first inspection.

We conducted our inspection on 10 and 11 October 2018. The inspection was announced. Shortly before our inspection, the provider had won a new contract from the local authority which had resulted in significant numbers of new clients and staff transferring to the service from another domiciliary care provider. At the time of our inspection 125 people were receiving a personal care service.

The service had a registered manager. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (the ‘provider’) 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.

Staff had established warm, friendly relationships with people and went out of their way to help them in any way they could. Staff worked together in a supportive way and participated in a varied programme of training appropriate to their needs. They were proud to work for the provider and felt listened to by the registered manager and other senior staff. The registered manager had an open and reflective leadership style which set the cultural tone for the service

People were involved in agreeing the type and amount of care they received and their needs and wishes were understood and followed by staff. In general, people were satisfied with the provider’s staffing arrangements although the recent expansion of the service had caused disruption to call timings and staffing continuity for some people. The provider was aware of these issues and action was in hand to address them.

Staff treated people with dignity and respect and encouraged them to maintain their independence. Staff had the knowledge and skills required to meet people’s individual needs effectively and supported them to prepare food and drink of their choice.

People received any support they required to take their medicines and staff worked closely with local healthcare services to ensure people had access to specialist support when needed. The provider assessed any potential risks to people’s safety and welfare and put preventive measures in place where required. Staff knew how to recognise and report any concerns to keep people safe from harm.

The provider sought people’s opinions through regular customer surveys and people were generally satisfied that any complaints were handled effectively.

The provider was committed to the continuous improvement of the service and maintained a range of systems to monitor service quality. Action was required to ensure CQC was always notified of any significant incidents or events.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. Staff understood the principles of the MCA and how to support, in the least restrictive way possible, people who lacked capacity to make some decisions for themselves.