We undertook our comprehensive inspection of the Innovate Building Domiciliary Care Agency (DCA) between 31 July 2018 and 07 August 2018. We visited the services’ office on 31 July 2018 and 07 August 2018. The visits to the Innovate building were announced at short notice, as we needed to be sure there were the appropriate people available for us to speak with.

We previously inspected the service between the 08 March 2017 and 09 March 2017 and the rating after this inspection was ‘requires improvement’. There were no breaches of regulations at this previous inspection. At this latest inspection we found the provider had improved the service sufficiently for us to rate the service as ‘good’.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Dependent on people’s needs carers may ‘live in’ to provide support throughout the day and night. The service may provide personal care to children from four years old to 18 years old and adults (younger or older) living with dementia, learning disabilities/autistic spectrum disorder, mental health, physical disability or sensory impairment. At the time of our inspection there were 22 people receiving personal care. Not everyone using the Innovate building receives a 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 consider any wider social care provided.

Some of the people receiving personal care live in a ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service does not currently have a registered manager as they had deregistered 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. There was an acting manager in place though, and they were looking to apply to us to become the registered manager.

People told us deployment of staff had improved with people allocated staff they knew who were part of a smaller team. This meant they received the same staff more consistently. People were protected from abuse as staff knew how to respond to allegations of abuse, and people were aware of how to raise concerns. People were happy with the way their medicines were managed. There were appropriate checks on new staff to ensure they were safe to work with people.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff were well trained and people expressed confidence in staff’s ability to meet their needs. People were supported to access community healthcare as needed. People had the support from staff need to ensure they had sufficient food and drinks of their choice.

People received support from staff who were kind and caring. Staff treated people with dignity and respect. People's independence was promoted. People could express their views and make choices regarding their daily living. Advocates were sourced for people when needed.

People’s individual car

The inspection was announced and took place on 8 and 9 March 2017. The Innovate Building provides personal care to people living in their own homes or in a supported living environment. At the time of our inspection the service was supporting 40 people. This was the services first inspection since they registered with us.

The provider had recently appointed two new managers for each of the services provision. The two managers had submitted their applications to us in order to register as registered managers for the service. 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 told us their calls were sometimes late or missed. Staffing levels were improving but required further improvement to ensure people received their calls on time and by a consistent team of staff. Staff were safely recruited and people told us they felt safe when receiving support from staff. Staff understood people’s risks and how to manage them. People who were supported by staff to take medicines received their medicines as prescribed by staff that had been trained and assessed as competent.

People were supported by staff that had the skills, knowledge and support to provide personal care to them. People’s rights were protected as the provider was appropriately applying the principles of the Mental Capacity Act. Staff sought people’s consent before providing care and support. People who were supported by staff to prepare and cook meals were provided with choices, and staff were aware of people’s specific dietary requirements. People were supported to access healthcare professionals if required.

People told us staff were kind and caring, they were respected by staff who supported them and were encouraged to make day to day decisions about their care and support. Staff promoted people’s privacy and dignity and encouraged their independence.

People were supported by staff who understood their needs and preferences. People and their relatives were invited to attend care reviews and provide their input. Staff were kept up to date with people’s changing care needs to ensure they were able to provide effective support. People knew how to raise a concern or complaint and there was a system in place to ensure complaints were appropriately managed.

Not everyone we spoke with felt the service was well managed. Systems and processes to monitor the quality and consistency of the service were not always effective at identifying required improvements. There were processes in place to enable people, relatives and staff to provide feedback on the service. However people were not always informed of the action taken to make any necessary improvements. Staff had a good understanding of their roles staff support had improved. The provider was appropriately notifying us of event they were required to do so by law.