iCall Care Office is a domiciliary care service providing care and support to people living in their own homes. The office is based in the city of Leicester and the service currently provides care and support to people living in Leicester. At the time of our inspection there were 25 people using the service who received personal care.

We previously carried out an announced comprehensive inspection of this service on 19 and 20 January 2016. We found that the provider was not meeting the standards we expected and there were breaches of legal requirements. We found people’s care needs and risks were not assessed or reviewed regularly. People were not always involved making decisions about their care. The care plans were not centred on people’s needs, were not kept up to date and lacked information for staff to support people safely. Staff were recruited without proper pre-employment checks being carried out. Staff were not provided with training and support to carry out their duties. We issued requirement notices as the provider was in breach of legal requirements. The provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

This inspection took place on 5 and 6 October 2016 and was announced. The provider was given 48 hours’ notice because the location provides domiciliary care service and we needed to be sure that someone would be at the office.

A registered manager was 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.

People’s care needs were assessed and measures were in place to manage risks. People were involved in the development of their care plans, which provided staff with clear information on how to support people safely.

People’s care plans were personalised and described how they wished to be supported and their views about the service were sought regularly. Staff were knowledgeable about people's preferences and how they wished to be supported, which promoted their wellbeing.

Staff were recruited in accordance with the provider’s recruitment procedures to ensure they were suitable to look after people living in their own homes. People were supported by the number of staff identified in their care plans to keep them safe and meet their needs.

People’s care needs were monitored and reviewed and their care plans were updated when their needs changed. The registered manager and staff had an understanding of the key principles of the Mental Capacity Act 2005. People told us staff asked their consent before providing care.

People told us they felt safe with the staff and care they received from the service. Staff were able to recognise signs of abuse and were confident to report concerns and protect people from harm.

People were supported to take their medicines safely. Staff supported some people, where required with their meals and drinks. Records showed staff worked with health care professionals and supported people to access healthcare services when required.

Staff received a range of training to ensure they had the skills and knowledge they needed to meet people’s care needs. Staff told us they were in regular contact with the management team who supported them to meet people's care needs.

People and relatives were positive and complimentary about the staff that supported them. They told us the staff were kind and caring, and responsive when their needs changed to ensure they were supported to stay safe and remain as independent as possible.

There was a complaints procedure and people knew how to use it. People and their relatives were confident that any concerns raised would be responded listened to and addressed.

People had confidence in how the service was man

We carried out an announced comprehensive inspection of this service on 19 and 20 January 2016. A breach of the legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was found. After the comprehensive inspection, the provider wrote to us to say what they would do to make the required improvements.

We carried out a focused inspection of this service on 8 June 2016 and 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 at the office.

We undertook this focused inspection to identify if the required improvements had been made. This report only covers our findings in relation to ‘Well-Led’. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for iCall Care Office on our website at www.cqc.org.uk

A registered manager was 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.

At the time of our inspection there were 25 people using the service. During our inspection visit we found the provider had made improvements to the way they managed the service.

The registered manager had attended training to update their knowledge in relation providing a quality care service. Improvements were made to ensure systems in place were effectively monitored to ensure the quality of care provided met the provider’s expectations of providing a quality service. The registered manager had updated the policies and procedures and checked practices within the service were up to date. Records showed staff were recruited safely and provided with the training and support to ensure people’s needs were met.

People’s care needs and risks to their wellbeing and safety had been re-assessed. The provider had introduced new care plans, which provided staff with clear information as to how to support people. These took account of how risks should be managed and were centred on the person’s preferences.

We found the provider’s quality assurance and governance systems were being used effectively to monitor the quality of service provided. The provider maintained accurate records and information relating to the people who used the service, staff and the management of the service. Information gathered from the regular audits and feedback from people who used the service, their relatives, staff and health care professionals was used to develop the service.

This inspection took place on 19 and 20 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides domiciliary care service and we needed to be sure that someone would be at the office.

iCall Care Office is a domiciliary care service providing care and support to people living in their own homes. The office is based in the city of Leicester and the service currently provides care and support to people living in Leicester. At the time of our inspection there were 26 people using the service who received personal care and social support.

A registered manager was 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.

People told us they felt safe with the staff that supported them. Staff were trained in safeguarding (protecting people who used care services from abuse) procedures and were confident to report concerns about people’s safety to the registered manager.

People’s safety was not protected because staff were not recruited properly and pre-employment checks were not carried out. Improvements were also needed to staff training, supervision and support because the systems were not in place to monitor and support staff effectively.

Risks to people health and safety in relation to the care and support they needed was not assessed properly. Measures to manage risk were not always detailed sufficiently in the plan of care. People’s care was not monitored or reviewed regularly and changes to their needs were not always acted upon. This meant that people received unsafe or inappropriate care.

The service had sufficient staff to meet people’s needs. People’s individual requirements were matched where possible, with any known requirements such as individual preferences, cultural or diverse needs.

People were prompted to take their medicines by staff where people’s assessed needs and care plans required this. Staff supported people to liaise with health care professionals if there were any concerns about their health.

People told us that staff sought consent before they were helped and that staff always respected their choices and decisions. However, improvements were needed to ensure the registered manager and staff understood their responsibilities and requirement to protect people under the Mental Capacity Act and Deprivation of Liberty Safeguards.

People had limited opportunity to be involved in decisions made about their care and their views about the quality of service provided. People did not always receive person centred care that was responsive to help maintain their health, safety and wellbeing.

People’s privacy and dignity was maintained, their choice of lifestyle was respected and their independence was promoted.

People were confident to raise any issues, concerns or to make complaints. However, the provider’s complaint procedure was not transparent and concerns raised were not recorded. Improvements to the service were limited as a result of a complaint.

There was a registered manager in post. The provider policies and procedures had clear guidance, tools and documentations to be used to ensure a quality and safe service was provided but these were not followed. The provider’s quality governance and assurance systems were fragmented and ineffective. Confidential information relating to the people who used the service, staff and the management of the service were destroyed. There was no evidence to demonstrate that the provider monitored, reviewed, and took steps to make improvements to the service. Therefore, improvements were needed.

We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the