The inspection site visit took place on 6 December 2017 and was announced. This service is a domiciliary care agency. It provides personal care to adults living in homes. Three people were receiving the regulated activity of ‘personal care’ at the time of our inspection visit.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

Following our inspection in November 2016, the service was rated as inadequate and placed in Special Measures. When we inspected the service in June 2017, we found some improvements had been made, but further improvements were required. The provider and registered manager had not been communicating openly with people and their relatives in a consistent and transparent way. This had led to misleading information being shared with one person about which registered service was providing a person's care and support, which was in breach of the Regulations. The service remained in Special Measures, because the lack of transparency reported under the key line of enquiry, well-led, had an impact on the ratings across all the key lines of enquiry.

The provider had not displayed their inspection rating from their November 2016 inspection, which was also a breach of the regulations. This was a continued breach of the governance of the service. The service remained in special measures because ‘well-led’ remained rated as ‘inadequate’.

The lack of transparency had meant there were breaches of the Regulations related to safety and consent, which resulted in ratings of requires improvement in safe, effective, caring and responsive. The provider had not conducted risk assessments for one person, had not obtained their consent to care, had not demonstrated a caring attitude, through their lack of transparency, and had not explained their terms and conditions, including how to make a complaint. This had resulted in ratings of requires improvement in safe, effective, caring, and responsive.

At this inspection we found the provider had taken action to improve. The provider had checked that everyone who used the service knew who their provider was. They had issued contracts to everyone and people or their representatives had signed their consent to receive care and support from this provider. They had implemented regular checks with everyone who used the service, to make sure they were happy with the how their care was delivered. They had regular meetings with everyone who used the service and invited them to feedback about any changes needed, or any concerns with the quality of the service. The provider had displayed their ratings at their office and on their website. The service is no longer in breach of the regulations and the rating for well-led is now good. The service has been taken out of special measures.

The registered manager had been registered with us since June 2016. 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 protected from the risks of harm or abuse because staff were trained in safeguarding and understood their responsibilities to raise any concerns with the registered manager. The registered manager had recruited enough suitably skilled, qualified and experienced staff to support people safely and effectively.

People and their relatives were included in planning how they were cared for and supported. Risks to people

This inspection took place on 14 June 2017 and was announced. We gave the provider 24 hours’ notice of our inspection. This was to make sure we could meet with them, the registered manager and talk with staff on the day of our inspection visit.

Glee Care Limited, Nuneaton is registered to provide personal care and support to people living in their own homes. The director of Glee Care Limited, who we refer to as the provider in our report, told us they did not currently have any people that used their service who lived in Nuneaton, Warwickshire. The provider told us they had three people that used their service in Leicestershire. During our inspection, we found there were four people using the service at the time of our inspection.

A requirement of the provider’s registration is that they have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered provider’s they are ‘registered persons.’ Registered persons have a 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 time of our inspection there was a registered manager in post who was also the provider; with their husband who was director of Glee Care Limited. Both the registered manager and director told us they also undertook most of the care visits to people that used their service.

The service was last inspected in November 2016. We found the provider had not made the required improvements identified to them at an earlier inspection, which was undertaken at their previous office site, (February 2016) and continued to be in breach of the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

In November 2016, we rated the service ‘inadequate’ and placed them in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this time frame. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action.

We met with the provider to discuss our concerns and have since kept the service under review. We notified the local authority commissioners about the serious concerns we had found that related to the safety and quality of care that people received. The provider was asked to submit an urgent action plan to us to tell us how they were going to mitigate risks to people, which they did.

Following our November 2016 inspection, the local authority told us they were no longer commissioning services for people from the provider, and the provider told us they had no people using their services. In March 2017, the provider contacted us to say they had a small number of people now using their service. At this inspection, we checked on the improvements that had been made.

At this inspection we found insufficient improvements had been made to remove the service from special measures. We found continued breaches of the regulations that related to people’s safe care and in the governance of the home. The provider and registered manager had not always openly communicated with people and their relatives in a transparent way which had led to misleading information being shared about