We inspected Goldsmith Personnel Limited on 23 October 2018. The inspection was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. Our last inspection took place on the 23 and 28 June 2017 and we found one breach of regulation in relation to safe care and treatment. At this inspection we found improvements had been made.

Goldsmith Personnel Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Goldsmith Personnel Limited receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection it was providing a service to 90 people.

There was a registered manager at the service at the time of our 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 and associated Regulations about how the service is run.

People told us they felt the service was safe, staff were kind and the care received was good. We found staff had a good understanding of their responsibility with regard to safeguarding adults.

Risk assessments were in place which provided guidance on how to support people safely. There were sufficient numbers of suitable staff employed by the service. Staff had been recruited safely with appropriate checks on their backgrounds completed. Medicines were managed safely.

Staff undertook training and received regular supervision to help support them to provide effective care. Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA). MCA is legislation protecting people who are unable to make decisions for themselves. People and their relatives told us staffing treated them with dignity and respect.

Person centred support plans were in place and people and their relatives were involved in planning the care and support they received.

People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

The provider had a complaint procedure in place. People and their relatives knew how to make a complaint.

At the time of our inspection the service did not have any people receiving end of life care. The service had an end of life policy in policy. Staff received end of life care training.

Staff told us the registered manager was supportive. People and their relatives felt the service was well led and had a good relationship with office staff. The service had various quality assurance and monitoring mechanisms in place.

The inspection took place on 23 and 28 June 2017 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service for adults; we needed to be sure that someone would be in. Goldsmith Personnel Limited provides personal care to people living in their own home. The service provides care and support for older adults, people with disabilities and children. At the time of our inspection there were 50 people receiving care. The service was last inspected in July 2014 and was rated as Good.

There was a registered manager at the service at the time of our 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 not always protected from risks to their health and wellbeing because risk assessments to guide staff were inconsistent and did not always provide sufficient detail for staff about how to manage specific risks.

The provider followed the latest guidance and legal developments about obtaining consent to care. However, people had not always signed to consent to their care where they had transitioned from being a child who used the service to an adult using the service. Staff used a range of communication methods to support people to express their views about their care.

People felt safe and were protected from the risk of potential abuse. Staff were knowledgeable about safeguarding and knew what to do if they had concerns about the service. The staff were suitable to work in the caring profession and recruited appropriately.

Medicines were well managed and the service conducted regular audits of medicine administration.

Staff were trained to carry out their roles and newly appointed staff were supported in their role by a robust induction period.

People were supported to get enough to eat and drink and people had access to healthcare professionals.

There were enough staff to meet people’s needs and people consistently received care from the same care staff member. Staff developed caring relationships with people using the service and respected people’s diversity and privacy. People and their relatives were involved in planning their care and care records included information about people's likes and dislikes and promoting their independence.

There was a positive and open culture at the service. People using the service and their relatives felt confident that they could raise concerns and their complaints would be taken seriously.

We made three recommendations in relation fit and proper persons employed, consent and good governance. We found one breach of the Regulations around safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. This was an announced inspection and we gave the manager two days notice of the inspection.

Goldsmith Personnel Limited provided personal care to people living in their own home or in supported living accommodation. The agency provided care and support for older adults, people with disabilities and children. Approximately 70 people used the service.

The agency had a registered manager. A registered manager is a person who has registered with the   Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

We spoke with 23 people who used the service and three relatives. All the people we spoke with said they felt safe using the service. The provider had policies and procedures which they used to keep people safe and minimise the likelihood of abuse. Staff were knowledgeable about safeguarding adults and what to do if they had concerns about abuse. Risks to individuals who used the service were identified and managed. Staff were vetted for their suitability to work with vulnerable people as part of their recruitment.  There were sufficient numbers of suitable staff to keep people safe and meet their needs.

The provider supported people to receive their medicines safely. Medicines were managed in line with the provider’s medicines procedures, including appropriate use of procedures under the Mental Capacity Act where people lacked mental capacity to consent to care and treatment.

All the people and relatives we spoke with said they were happy with their care.  People’s needs were assessed and planned. Individual care plans provided information to staff about how to meet people’s needs.

Care was personalised and effectively provided to meet people’s needs.

People were supported to maintain good health and staff worked with healthcare professionals to meet the healthcare needs of people.

Staff had training and support to understand their roles and responsibilities. They were familiar with people’s needs and how to meet them.  Each person had a main care worker who was involved in their assessment process.

People were helped to maintain good nutrition according to their needs.

People said staff were kind, caring and respectful to them. Staff respected and promoted the dignity of people.

People’s diverse individual needs were taken into account when planning and delivering their care.

The provider listened and learned from people’s experiences, concerns and complaints to improve the quality of care.

Staff received training and support and knew how to respond to incidents affecting the safety and wellbeing of people when conducting home visits.

The provider was able to demonstrate good management and leadership. There were systems in place to monitor the quality and effectiveness of the service. The provider developed an open and positive culture to encourage open communication with staff and people who used the service. There was a focus on delivering quality care that promoted and reflected best practice.

We carried out this follow-up inspection visit to check upon the non-compliance found at the previous inspection in May 2013. At the previous unannounced inspection we found the service could not demonstrate that staff received regular training, supervision or annual appraisals. Following the inspection in May 2013, the service provided us with an action plan to state how they would make improvements.

We found at this inspection visit that the service could now demonstrate that staff received regular training and supervision, as well as annual appraisals. We saw that care workers and office staff also attended group meetings to discuss professional issues and share information.

We spoke with the office manager and two care co-ordinators about the training and support provided for staff, and we checked six staff files. We also looked at other relevant documents, such as the minutes for staff meetings.

During this inspection we spoke with four people using the service and the relatives of two other people. All of the people we spoke with said they were pleased with the service. One person said, "I think I have struck gold with my care workers. They are a very good bunch of staff and seem well trained."

People told us they were consulted about their care and involved in developing their support plans. We spoke with five care workers who all demonstrated their understanding of gaining people's consent to care.

We found that people's care needs were assessed and recorded in their care plans. Relevant risk assessments had been carried out to make sure people were cared for safely. People told us they felt safe with their care workers and the five care workers we spoke with all demonstrated an understanding of how they would protect vulnerable people from the risk of abuse.

The agency had appropriate recruitment policies and procedures to make sure that all necessary pre-employment checks were conducted. This meant that people using the service were cared for and supported by suitable staff. We saw that staff received supervision, but the agency could not demonstrate that staff were supported to meet people's needs through regular training and annual appraisals.

The service had procedures for monitoring the quality of services provided, to make sure people using Goldsmith Personnel Limited received the care and support they needed.

We did not speak to people using the service during this inspection. We checked issues that had been identified at previous inspections and found that these had been addressed by the provider.

We also looked at staff recruitment practices, having received information from a safeguarding investigation regarding the unsatisfactory recruitment of a care worker.

People we spoke with told us they were able to express their views and preferences with the managers and carers at Goldsmith Personnel Limited. Many of the positive comments we received about the service showed that people felt comfortable expressing their views and were involved in making decisions about their care.

People said very good things about Goldsmith Personnel Limited. They particularly praised their care workers for providing good care, being respectful and supportive to them.

None of the people using services we spoke with raised any concerns about the care workers from Goldsmith Personnel Limited.

Goldsmith Personnel Limited was conducting their annual monitoring survey at the time of our inspection, and the provider had already received a good rate of response (about 50%) from people using services.

Generally people responded extremely positively in the survey, were very happy with all aspects of their care and spoke well of their care workers.

However, we found that Goldsmith Personnel Limited does not have a staff member in post to manage the carrying on of a regulated activity as the registered manager.

Most people using services that we spoke with were happy with the care workers from Goldsmith Personnel Limited. They told us they were well cared for, that their care workers came along to care calls on time.

We found that staff members took appropriate actions if they suspected people who receive services were being abused, or were at risk of being abused. However we identified that improvements were needed to the arrangements for training care workers and the monitoring of the quality of services.