This inspection took place on 31 July to 3 August 2018 and was announced giving five days’ notice so that we could obtain information to help us with the inspection.

At the last inspection on 15 to 21 December 2016, we found the provider was in breach of Regulation 9 (Person centred care), Regulation 12 (Safe care and treatment), Regulation 13. (Safeguarding service users), Regulation 17 (Good governance), and Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We rated the service as ‘Requires improvement’ in all areas with an overall rating of ‘Requires improvement’.

Following the inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve all the key questions to at least ‘Good’.

We found significant improvements had been made to the service when we returned on 31 July 2018, and the service was no longer in breach of the Regulations. We have judged their rating to be 'Good'.

Ideal Home Care Solutions provides a domiciliary care service. It is registered to provide the regulated activity of personal care and treatment of disease, disorder or injury to people in their own homes, including older people, people with dementia, people with a physical and sensory impairment and younger adults. At the time of the inspection, the service was caring for 145 people with 74 staff supporting them.

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.

Systems were in place to ensure people felt safe. Missed and late calls had been significantly reduced through the implementation of technology which monitored staff movement of calls, rota arrangements and identified early action to take. The service had reviewed its staffing levels and arrangements and sufficient staff were in post to keep people safe. Additional management staff had also been employed to supervise the day to day delivery of care.

Care was provided in a safe way as the service now managed the risks to people’s health and wellbeing. Improvements had been made to people’s assessments of need and any risks associated with providing their care. These were carried out and provided detailed guidance to staff in caring for them safely. People told us that they were listened to, respected and communication with the management of the service had significantly improved.

The management of medicines had been improved and staff now recorded accurate information about how they administered people’s medicines. Systems were in place to ensure medicines were monitored and, staff competency to administer them, was checked and recorded.

The recording of information in people’s care plans had been improved to ensure staff understood and implemented the guidance and advice from professionals so that people received effective care. The recording of people’s needs and the review of their care was now accurate and consistent. The daily notes were person centred, respectful and clear.

Systems to monitor the quality of the service had significantly improved and were all in place to ensure the oversight of the service and the provision of high-quality care.

Staff knew how to protect people from the risk of harm. They had received training in how to recognise the signs of abuse and knew how to report any safeguarding concerns to their managers.

People were cared for by staff who had been safely recruited. Staff did not start work until all required employment checks had been carried out. Staff had the skills and knowledge to care and support people effectively.

Staff understood how to minimise the risk of infection, they had been trained, and had access to person

We carried out an announced inspection of the office location on 15 and 16 December 2016 and we further followed up information by contacting people who used the service and staff.

Ideal Home Care Solutions provides a domiciliary care service to people in their own homes. The domiciliary care service provided care and support to 173 people and 101 staff supporting them at the time of our inspection.

A registered manager was in post and the service was well established. The registered manager was also the joint owner of 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 were not being kept safe as calls were often late or missed resulting in people not having the care they required at the time they required it. There were insufficient staff deployed to meet the individual needs of people who used the service

Risk assessments, care plans and reviews were not sufficiently detailed to provide staff with an accurate description and understanding of people’s care and support needs.

Systems were not in place to ensure that people received their medicines safely, in a timely way and the process was checked to ensure people were kept safe.

The service was not always caring as arrangements of the rotas meant that people would not get their assessed needs met as staff would not have sufficient time to listen to them and involve them in making decisions.

Quality assurance systems were in place but were not being used to monitor and evaluate the service effectively to provide a high quality service.

There was visible leadership in the service with a clear vision and values. The management arrangements had been improved with the implementation of a new staffing structure to manage staff arrangements. Staff told us that they were mostly supported in their role and received encouragement to do their job well.

People were cared for by staff that had been recruited and employed after appropriate checks were completed. Staff had most of the skills and knowledge to provide care and support to people.

Induction, training and support system was in place for staff including supervision, appraisal, and competency checks in carrying out their role.

Complaints and concerns were logged and the management acted on the information about the quality of care people had received.

We inspected Ideal Home Care Solutions on 17 April 2013. We spoke with people who used the service and their relatives. They told us: “On the whole they are lovely. They always come in and check and ask first before they do anything.” We were also told: “The carers are very kind and considerate.”

During the inspection we spoke with nine members of staff, one of whom told us: “This is one of the better companies I have worked for, especially with back up and supporting you in the job.” The staff members we spoke with were knowledgeable and professional. They told us; “We used to have weekly training sessions but they stopped; now we get them once a week. The coordinators are constantly in touch, I’m always getting phone calls or text messages giving me updates and letting me know of any changes [to peoples care needs].”

We found the care records we looked at to be organised, person centred and easy to read. There were policies and procedures in place for the protection of people who used the service. People told us they were happy with the service.

The inspection took place on 23, 25 and 27 April 2015 and was announced.

Ideal Home Care Solutions Ltd is a domiciliary care agency, delivering services in the South Woodham Ferrers, Chelmsford, Clacton-on Sea, Harwich and the surrounding areas of Essex. The agency offers a variety of personal care services, including domestic support, respite care and live in care.

The service has 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 the last inspection in July 2014, we identified three breaches of the legal requirements. We asked the provider to make improvements as risks and medicines were not being managed safely. We also identified that the quality systems which were in place were not effective.

At this inspection we saw that improvements had been made to medicines management and the processes for staff to follow were more robust.

People were safe and staff knew what actions to take to protect them from abuse.

Risk assessment processes were being updated as part of a new care planning process; however these focussed mainly on environmental risks and did not always provide staff with sufficient guidance on people’s individual risks.

Recruitment processes were generally satisfactory although there was an oversight in one of the files we viewed, which had the potential to place people at risk.

People received support from trained staff who were regularly supervised.

Staffing was organised to ensure that people received care from a consistent team of staff. There were arrangements in place to respond to unforeseen events but we did receive some feedback about the impact of late calls, in one area. The management of the agency were looking at how they could make further improvements in this area.

The provider had policies in place with regard to the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act (MCA) 2005. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. Care staff had a good understanding of the importance of obtaining consent and protecting people’s rights.

People were supported with meals and staff at the service worked with health professionals to support people with their health care needs.

People’s independence was promoted by staff and people felt involved in their care. They had good relationships with the staff and were treated with dignity and respect.

The provider had a complaints procedure and there were records to show that matters were investigated and responded to. People had confidence that concerns would be investigated and addressed.

There were a range of systems in place to monitor the quality of the service being delivered. This included people’s views as well as a range of audits. The service benefited from a clear management structure and visible leadership.