This inspection took place on 19 July 2017 and was announced. We gave the provider 48 hours’ notice that we would be visiting. This was because the provider offers a support service to people living in their own homes and we wanted to make sure that people and staff would be available to speak with us.

Hafod Care in the Community is a community based adult social care service, registered to provide personal care for persons within their own home. They currently provide a service for 23 people.

There was a registered manager in post 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.

Hafod Care in the Community were last inspected in May 2015 and were rated as a ‘Good’ service, but were seen as requiring improvement in the domain of Well Led.

Staff rotas were not effective to ensure that staff had sufficient time to attended care visits. Training planning was ineffective, as staff were given insufficient notice, resulting in courses being cancelled and rescheduled. Auditing processes had not identified these issues.

People were kept safe. Staff had received training and understood the different types of abuse and knew what action they would take if they thought a person was at risk of harm. People were kept safe by staff who were able to recognise the signs of abuse and raise concerns if needed. Staff were provided with sufficient guidance on how to support people’s medical needs.

People were supported by staff that had been safely recruited. People felt they were supported by staff with the appropriate skills and knowledge to care and support them.

Staff had the knowledge and skills to enable them to care for people in a way that met their individual needs and preferences. People were supported to make choices and were involved in the care and support they received. Staff had an awareness of the Mental Capacity Act and Deprivation of Liberty Safeguarding (DoLS).

Staff were caring and treated people with dignity and respect. People’s choices and independence were respected and promoted and staff responded to people’s care and support needs.

People and staff felt they could speak with the provider about any concerns and felt they would be listened to and their concerns would be addressed.

The provider ensured that all policies and procedures were kept up to date with current guidance and legislation. There were quality assurance and auditing systems in place to ensure continual development of the service for the people being supported by the provider.

The inspection took place on 27 May 2015 and was announced. We told the registered manager two days before our visit that we would be visiting to ensure the registered manager was available.

Hafod is a domiciliary care service that provides care and support to people living in their own homes. Some people’s care was funded through the local authority and some people purchased their own care. At the time of our inspection nine people received support from this 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.

All staff spoken with knew how to keep people safe from abuse and harm because they knew the signs to look out for. Where incidents had occurred the provider took appropriate actions to escalate the concerns and help in reducing re occurrences.

People were protected from unnecessary harm because risk assessments had been completed and staff knew how to minimise the risk when supporting people with their care.

Staff were safely recruited and trained to meet people’s needs.

People were supported with their medication when required and staff had received training so people received their medication as prescribed.

People were able to make decisions about their care and were actively involved in how their care was planned and delivered.

People were able to raise their concerns or complaints and these were thoroughly investigated and responded to so that people were confident they were listened to and their concerns taken seriously.

Staff supported people with their nutrition and health care need. Referrals to healthcare professionals were made in consultation with people who used the service if there were concerns about their health.

Processes were in place to monitor the quality of the service provided. However information was not analysed to identify if improvement were required. The manager had not updated her knowledge in relation regulation that the provider are required to meet as part of their registration.

We carried out this visit in response to concerning information we had received. We were told that people’s care calls were missed by staff and staff did not always arrive on time. We were told complaints were not always investigated. We spoke with the manager, three people using the service, one relative and Birmingham City Council.

People received care that met their needs. All three people spoken with told us that they had not experienced missed care calls. One person told us, I am happy with the staff that comes, they are kind and jolly’’

The provider had systems in place to support people using the service to make comments or complaints. One person told us, “The staff are very good, never had a cause to complain, I know I can ring the office and they would sort it out’’.

The provider did not have adequate systems in place to ensure people using the service received their calls as specified by their initial assessment of their care needs.

There were seventy people using the service on the day of our visit. We spoke with four people using the service, four relative, three staff and the manager. People were supported in a way that enables their privacy, dignity and independence to be respected. One person told us, “Staff ask my permission before they do anything.they treat me as an individual and my wishes are respected. All of the people spoken with commented that they were happy with the service provided. This meant people preferences were respected.

Staff spoken with were able to tell us about people's care needs so that they were cared for appropriately. One person told us “I am pleased with the service I have, the staff look after me well, I am very happy to see them''. All four people using the serivce told us that do what is asked of them. This meant people received the care they wanted

We saw that systems were in place to keep people safe from harm.

Staff received a range of training so that they had up to date knowledge and skills in order to support people safely.

There were systems in place to monitor and seek feedback from the people using the service to ensure people received a quality service.

We visited the service on 7 and 9 March 2012. The service was providing to approximately seventy adults at that time. We followed the care of three people aged from forty to over one hundred. Two people had dementia. One person had high care needs from physical illness.

We saw in each person's care file an assessment of their needs that had been undertaken by the provider. The assessment referred to any risks that the person's condition presented. Each person had an up to date care plan that was individual to them. Management plans for risks that had been assessed were written into care plans. Records were kept of each visit made to the person by care workers.

We saw from training files that care workers held qualifications in social care. They also had regularly up dated training in health and safety topics, the safe administration of people's medication and safeguarding vulnerable adults from abuse. They had at least four meetings on a one to one basis with a manager each year to talk about their performance and development.

The provider had written policies and procedures to guide workers including on safeguarding. We have asked the provider to improve the written policy on whistleblowing to make it relevant to the type of service being provided.

We spoke to care workers about the people they looked after. Workers were familiar with their care plans and the agreed way for managing any risks. They spoke about people with interest and warmth.

We spoke to a relative of one person whose care we followed. They told us that workers were generally punctual. They said that workers were 'really good' and had been 'very helpful.' They said that the they found it easy to communicate with the agency office when they needed to.

The provider had mostly informal systems in place for monitoring the quality of the service and care that people received. We have asked it to improve on this.

The manager is not registered with us. We are intending to write to the provider company about this.