This inspection took place on 30 June and 7 July 2017 and was announced. This means the provider knew we were coming. At the last inspection on 3 and 6 May 2016, the service was rated requires improvement. We also found the provider had breached the regulations in relation to safe care and treatment, the need for consent, staffing and person-centred care.

The service provides an on-site domiciliary care and support service to people who are tenants within Seafarers Way extra care scheme. The scheme is aimed at people living with dementia. The scheme can accommodate up to 38 people. At the time of our inspection there were 35 people receiving a care 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.

Since our last inspection the provider had improved the effectiveness of the risk management processes in the service. Where a potential risk had been identified a risk assessment had been carried out to help keep people safe.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Best interest decisions had been made on behalf of some people using the service. Care staff were not following current good practice by not always documenting a Mental Capacity Assessment in respect of these decisions. We have made a recommendation about this.

A new format for assessing people’s needs and support planning had been introduced. This prompted staff to gather information about people’s needs and preferences. This information was used to develop detailed and personalised support plans for each person. Support plans were reviewed in line with the provider’s expectations.

People were happy with the care they received and said staff were kind and caring.

Previous safeguarding concerns had been dealt with in line with the provider’s procedures.

Medicines records were accurate and accounted for the medicines people had received. Staff were trained and assessed to confirm they were competent to administer medicines. Medicines audits were effective in identifying issues relating to medicines.

There were effective recruitment processes to ensure new staff were suitable to work with people using the service. For example, requesting and receiving references and checks with the disclosure and barring service (DBS).

Incidents and accidents were logged and monitored to ensure action had been taken to keep people safe.

A business continuity plan had been developed to guide staff through how to deal with emergency situations.

Staff received the training and support they needed. Records confirmed training, supervisions and appraisals were up to date when we inspected the service.

One complaint received had been investigated and resolved in line with the provider’s complaint procedure.

People and staff had opportunities to give feedback and share their views about the service. Regular staff meetings took place and questionnaires were sent out to people to gather their views. The provider had received positive feedback about the service.

There were effective systems in place to check on the quality of people’s care. These included checks of falls, complaints, medicines, people’s daily records and support plans. A senior manager also regularly carried out checks of the service.

This inspection took place on 3 and 6 May 2016 and was announced. This was the first inspection of the service since it was registered with the Care Quality Commission on 13 November 2014.

The service provides an on-site domiciliary care and support service to people who are tenants within Seafarers Way extra care scheme. The scheme is aimed at people living with dementia. The scheme can accommodate up to 38 people. At the time of our inspection there were 35 people receiving a care 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.

During this inspection we found the registered provider had breached the regulations. Support plans did not always reflect people’s current needs or the fact they were living with dementia. Support plan evaluations were infrequent and lacked meaningful information about whether support plans were still relevant to people’s needs.

The registered provider was not following the requirements of the Mental Capacity Act (MCA) 2005 to support people who lacked capacity to make appropriate decisions about their care. Some decisions had not been made in line with the MCA or followed the required process, such as for the secure storage of people’s medicines.

Risk assessments had not been completed for all identified risks and the controls in place to manage risks were not always documented.

Care workers had not completed all of the training they needed so that people received safe and appropriate care. In particular, training records showed care workers had not completed dementia awareness training, MCA or positive behaviour training. There was a lack of knowledge and awareness within the service of how support people positively when they were anxious or agitated.

You can see what action we have asked the registered provider to take at the back of the full version of this report.

People said they received good care from kind and caring staff. One person commented, “They are very, very good. I have great help coming in helping me and I appreciate it.” Another person said, “They are very good, very helpful.” A third person told us, “I can’t grumble, they are very, very good.” People also commented they were treated with dignity and respect.

People and care workers said the service was a safe place to live.

Medicines administration records had been completed in line with the provider’s current medicines procedure. Medicines records were checked regularly to ensure they were completed correctly. One person told us, “Care workers visit at least four times a day to give me my tablets. Odd times they are late but not often.”

Care workers showed a good understanding of safeguarding and whistle blowing. None of the care workers we spoke with raised any concerns about people’s safety. However, they knew how to raise concerns and told us they would do so if they had concerns. One care worker told us, “The residents come first. Concerns would be dealt with. [Registered manager] is a good listener.”

People using the service said there were sufficient care workers on duty to meet their needs. Care workers also confirmed staffing levels were appropriate. There were effective checks in place to confirm prospective new care workers were suitable to work with the people using the service. This included requesting references and carrying out Disclosure and Barring Service (DBS) checks.

Incidents and accidents were logged and action taken to keep people safe. People’s support needs in an emergency were documented for care workers to refer to.

Care workers told us they were well supported by the registered manager and the rest of the staff team.

People were supported to e