About the service: Future Care & Support Service is a domiciliary care agency that was providing personal care and support to two people living in their homes at the time of the inspection.

People’s experience of using this service:

We were not able to speak with either people using this service however our findings suggested the quality and safety of the service remains inconsistent. A staff member told us they felt supported and showed care and concern for the person they supported. A healthcare professional spoke positively about the service and its benefits for a person. Another person continued to experience late calls and this issue had not been adequately addressed as found at our last inspection in June 2018. Records were not accurately maintained and staff had not received all training relevant to the support they provided.

The provider had gathered people’s feedback on occasions and this was often positive. Improvements were still required to systems and processes to ensure people consistently received a good, safe and effective service.

More information is in the full report.

Rating at last inspection: Requires Improvement; June 2018.

Why we inspected: We inspected this service as this was scheduled based on the previous inspection rating.

Enforcement: This inspection identified a continued breach of the regulations around governance. We found the provider was also in breach of their conditions because they had failed to appropriate notify the Commission of a change to their registered location. Please see the end of the full report for action we have told provider to take.

Follow up: After our inspection we shared our findings with the local authority. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This announced inspection took place at the provider’s office on 26 June 2018 with phone calls undertaken to people with experience of the service on 27 June 2018. The provider was given a short notice period that we would be undertaking an inspection. At our previous inspection in February 2016, the provider was rated as ‘Good’ in all key questions asked.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our inspection three people were receiving personal care from the provider.

There was a registered manager, but they were not present during the inspection. 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 supported by staff who had received training in how to protect people from abuse and were aware of their responsibilities to report any concerns they may have.

People felt safe when supported by staff but risks assessments had not been completed which would provide staff with information on how to support people safely.

Systems were in place to ensure people were supported by sufficient numbers of safely recruited staff. There was no system in place to monitor that staff attended calls at the correct time.

Staff were aware of their responsibilities to support people to take their medicines, but care plans were not in place for this and the prompting of medicines was not recorded consistently.

People were protected from the spread of infection as staff had access to the appropriate personal protective equipment.

Where accidents and incidents took place, the information was recorded but was not analysed to identify any potential trends or actions to take to reduce the risk of events re-occurring.

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.

People were supported by staff who they described as kind and caring. Staff treated people with dignity and respect and supported people to make choices regarding their daily living. People were encouraged and supported to retain their independence.

People were involved in the development of their initial care plan but records seen were not accurate and up to date. People were supported by staff who knew them well and understood their likes, dislikes and what was important to them.

People had no complaints but were confident if they did raise a concern, it would be dealt with appropriately.

Governance systems were not in place to provide the registered manager with an oversight of the service. Areas of concern that had been identified on inspection had not been identified by the registered manager or members of the management team.

Both staff and people supported by the service, were complimentary of the registered manager. Staff felt supported and listened to by both the registered manager and their colleagues.

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

We last inspected this service in July 2013. At that time the provider was compliant in all the areas looked at. This inspection took place on 27 November 2015 and was announced.

This service provides care and support to people in their own homes. Some of the people using the service live in property which is owned by the provider. At the time of the inspection there were six people using the service.

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 using this service told us that they felt safe. There were good systems for making sure that staff reported any allegation or suspicion of poor practice and staff were aware of the possible signs and symptoms of abuse.

People told us that they were happy with the service provided. People told us that they were included in decisions about how their care was provided. People told us about how staff helped them to retain skills and to stay as independent as possible.

People told us that staff treated them with dignity and respect. Staff working in this service understood the needs of the people for whom they provided care. Staff were aware of people's needs arising from their medical conditions.

Staff were appropriately trained and skilled to provide care and support to people. The staff had completed relevant training to make sure that the care provided to people was safe and effective to meet their needs.

The registered manager and staff we spoke with understood the principles of protecting the legal and civil rights of people using the service. We did not find anyone being deprived of their liberty.

The registered manager encouraged feedback from people who used the service, their family members, advocates and professional visitors, which she used to make improvements to the service, where needed.

The registered manager assessed and monitored the quality of care consistently. In addition to observations and supervision of staff, the manager consulted people using the service to find out their views on the care provided.

Our visit was discussed and arranged with the service in advance so that we had time to see and speak with staff. During our visit we spoke with two care staff and three senior members of staff including the provider's home care manager and the registered manager.

Following our visit we also spoke with five people who used the service by telephone to ask them about their experiences of the service. The people we spoke with had mixed opinions about the care and support they received. Comments included: “I think they are brilliant, they are so helpful”; “I have nothing but good things to say about them” and “They do nothing for me.”

Overall we found the care and support had improved since our last visit. People received more timely visits and most people felt they received the care they needed.

Processes for the recruitment of staff helped to ensure that people were cared for by suitably skilled and experienced staff.

Staff had access to equipment and guidance so that they could minimise the risk of cross infection to people receiving a service.

The provider had systems in place to improve the quality of the service people received. Staff described improved communication between staff and managers to ensure people received the care they needed. People also received more contact with managers so that any issues arising were dealt with more quickly leading to fewer complaints.

The people we spoke with who received personal care from the agency were happy with the quality of care received.

People told us that the agency had liaised with the referring agency and looked at the assessment documentation before the service commenced. People were invited to visit the temporary accommodation before they agreed to commence the rehabilitation process. People had a copy of the care and support plan in their home. People we spoke with were confident that they could raise concerns if they were not happy with the care being received and that they would be listened to.

People told us they were happy with the support they received and that it made a difference to their everyday living. People told us that they were treated with respect and that care staff maintained their privacy and dignity. They told us that care staff completed the care and support required. There was no delay in care staff attending to people’s needs because they worked shifts that covered 24 hours,seven days a week. This meant that they were on site at all times.

As part of our inspection of Future Care and Support service we spoke with four people who used the service and the relative of one person who used the service to ask them about their experiences. This was done in person during our inspection visit and by telephone the day after our visit.

People receiving respite care were generally more satisfied with the service than people who received home care. People using the respite service told us “The staff go beyond the call of duty”. Another person said “It’s (the service) been good.” People using the home care service raised issues relating to staff turning up late and difficulties contacting the provider if they wanted to raise a concern.

We found that staff rotas did not give adequate time for carers to travel between people. The current complaints system did not provide assurance that complaints were being dealt with consistently and had where possible been resolved to everyone’s satisfaction.