Holistic Social and Care Solution is a domiciliary care agency which is registered to provide personal care support to people in their own homes. At the time of our visit the agency supported one person with their personal care.

As we could not answer all the key lines of enquiry (KLOE) against the regulated activity we were not able to award a rating for the service.

This inspection took place on 13 September 2017, and was announced. We had told the provider 48 hours before the visit we were coming so they could arrange for staff to be available to talk with us about the service.

The home had 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.

At our last inspection in July 2016, there was one breach of the legal requirements and Regulations associated with the Health and Social Care Act 2008. (Regulated Activities) Regulations 2014. This breach was in relation to governance and oversight of the service. We found systems and processes to monitor the quality of the service were neither established nor operated effectively. The quality of the service was not assessed or monitored to ensure people’s care and support needs were being met. At the time there were 18 people using the service.

At this inspection, we found plans were in place to ensure the quality of the service was measured and action taken as a result of any issues or concerns identified. However, since our previous inspection, the number of people receiving support with personal care had reduced to one person only. Therefore, we could not be assured how effective governance and oversight was, as plans to ensure this was effective had not been fully implemented.

This meant the service remained in breach of one of the Regulations associated with the Health and Social Care Act 2008. (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People were protected from the risk of harm and abuse by staff who had been trained and understood their responsibilities. Risks to people were assessed, but these assessments were not always clear or detailed enough to give staff the up to date and accurate information they needed. However, staff knew the one person they supported well and took appropriate action to minimise any risks associated with their care.

People were supported by care workers who received an induction into the service when they first started work. Care workers told us they completed the training required to meet people's needs and had their practice checked to make sure they put their learning into practice.

The registered manager had an understanding of the principles of the Mental Capacity Act (MCA) and their responsibilities under the Act. Staff respected people's decisions and a relative told us staff were kind and caring.

Care records contained accurate information about the person’s support needs. Care calls were consistently provided at the times agreed. A relative was involved in planning their family member’s care needs and knew how to make a complaint.

Holistic Social and Care Solution Limited is a domiciliary care agency which is registered to provide personal care support to people in their own homes. At the time of our visit the agency supported 18 people with personal care and employed 20 care workers.

We visited the offices of Holistic Social and Solution Limited on 28 July 2016. We had told the provider 48 hours before the visit we were coming so they could arrange for staff to be available to talk with us about the service.

The service had 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. The registered manager was also the provider of the service.

All the people we spoke with had concerns about the times care workers arrived and most did not know what time their calls were supposed to take place. People said they never knew which care worker would be arriving. Some people said care workers stayed the agreed length of time; others were unsure how long their calls were supposed to be.

There was no structured system for allocating care workers to people’s calls to ensure people had calls at agreed times by regular care workers. As there was no system for scheduling calls the provider was unable to evidence there were enough care workers to provide all the care calls people required.

The registered manager’s knowledge of their regulatory responsibilities was not sufficiently robust to ensure they complied with the regulations to notify us of incidents and about any changes.

There were processes to monitor the service and understand the experiences of people who used the service. However there was no evidence to show that some quality assurance processes had been put into action to ensure the service always operated effectively and safely.

People knew how to complain but some had difficulty contacting the office to raise their concerns. Care workers were confident they could raise any concerns or issues with the registered manager and felt they would be listened to.

Care workers understood how to protect people from abuse and there were processes to minimise risks to people’s safety. These included procedures to manage identified risks with people’s care and for managing people’s medicines. Most checks were carried out prior to care workers starting work to ensure their suitability to work with people who used the service.

People were supported by care workers who received an induction into the service when they first started work. Care workers told us they completed the training required to meet people’s and had their practice checked to make sure they put their learning into practice, but there was no recorded evidence to support this.

The registered manager had an understanding of the principles of the Mental Capacity Act (MCA) and their responsibilities under the Act. Care workers respected people’s decisions and most people told us care workers were kind and caring.

Care plans and risk assessments contained relevant information for care workers to help them provide the care people required. Not all plans had been updated when changes had occurred and known risks to people's care had not always been assessed.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.