This inspection took place on 24 and 25 September 2018 and was unannounced.

Just ONE Recruitment and Training Limited is a domiciliary care agency registered to provide personal care to people in their own homes, including supported living settings. The service also provided 24-hour staffing in a building called Oakfield, where people owned their own flats, but shared some communal space. The agency office is based in Wavertree, Liverpool. The service supports people who live in Liverpool, Wirral and St Helens. At the time of the inspection they were supporting 64 people, however only 29 of those people were in receipt of a regulated activity; personal care. This inspection only looked at the support provided to people who received a regulated activity.

At the last inspection in July 2017, the provider was found to be in breach or Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the systems in place to monitor the quality and safety of the service were not always effective. We asked the provider to complete an action plan to show what they would do and by when, to make the required improvements and we received this. During this inspection we looked to see if the improvements had been made and found that they had.

A registered manager was in post and feedback regarding the management of the service was positive. 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 we found that the provider was in breach of Regulation 17 as staff training records were fragmented and the registered provider did not have a clear oversight to ensure it remained up to date. During this inspection we found that improvements had been made. Staff completed training relevant to their role and the needs of the people they supported and the registered manager maintained a matrix to oversee when refresher training was due.

Improvements had been made regarding the recording of medicines and the provider was no longer in breach of Regulation, however further improvements were still required as stocks of medicines were not always recorded and monitored appropriately. Following the inspection, the registered manager shared with us a new system that had been introduced to further improve the management of medicines.

In July 2017 we found that systems in place to monitor the quality and safety of the service were not always effective. During this inspection we saw that improvements had been made. Systems were in place to regularly review care files, medicine records and accidents/incidents. Weekly management meetings were held to discuss any staffing issues, concerns regarding packages of care, complaints, safeguarding incidents or accidents. The provider was no longer in breach of Regulation regarding this.

People we spoke with told us they felt the support they received helped to keep them safe. Risks to people had been assessed on an individual basis depending on the needs of each person and clear guidance was available about how staff could reduce the risk. Staff were knowledgeable about safeguarding processes, were aware of how to identify possible safeguarding concerns and told us they would not hessite to report any concerns they had.

People told us they received support from the same consistent staff team and that staff always arrived when expected. We saw that appropriate checks had been made when recruiting staff, to ensure they were suitable to work with vulnerable people.

Staff were supported through a comprehensive induction and regular supervision sessions. They told us they could always contact senior staff if they needed advice.

People’s needs were assessed prior to supp

This inspection took place on the 4, 11 and 17 July 2017; the first two days were unannounced. 12 Tapton Way is a supported living agency that provides care and support to people in their own homes. The registered provider is Just One Recruitment and Training Limited. Their office is based in Wavertree, Liverpool. At the time of this inspection they were supporting 44 people. The support ranged from a few hours a day to 24-hour support. 28 people lived across Merseyside and 16 people lived in their own apartments in a complex called Oakfield.

The agency does not have 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 in the Health and Social Care Act 2008 and associated regulations about how the service is run. There is a manager in post who has not yet applied to become registered with the CQC. At the time of our inspection the manager was on leave, so another senior staff member was acting manager in their absence.

At the last inspection in September 2015, the service was rated overall as Requires Improvement.

We found breaches of Regulation 11, 13 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

During this inspection we looked to see whether improvements had been made. At the last inspection there was a breach of Regulation 17, as the provider had not ensured that accurate and up to date records had been maintained. During this inspection we saw that records were up to date and accurate. However the providers systems for assessing, monitoring and improving the service had not been effective in highlighting and acting on issues.

Therefore during this inspection we found breaches of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Because we saw that the monitoring of people’s medication administration, staff training and the organisations response to incidents had not ensured that these areas had consistently remained safe and effective.

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

At our previous inspection in September 2015 we saw that people did not always receive their care as planned. This included staff not arriving on time or insufficient staff arriving to meet people’s needs. During this inspection people’s relatives told us that the service was reliable. We saw that new systems for organising rotas had been introduced and teams organised around individuals who received the service. One relative told us, “[Name] has a stable staff team and one hundred percent knows the person who knocks on their door.”

Previously we found that the service was not able to demonstrate that they could support a person safely within the law who did not have capacity to make their own decisions. Also staff did not receive training in the Mental Capacity Act 2005 (MCA). At this inspection we saw that staff had received training on the Mental Capacity Act. Supporting people in line with the principles of the MCA had improved and the practice was to assess a person’s capacity if they felt there was a valid reason to do so. We saw evidence of people giving consent to their care and if appropriate best interest meetings had been arranged. We did make recommendations that some people’s care plans were reviewed as they contained confusing information about people’s capacity.

During our previous inspection we found that systems and processes were not always operated effectively to prevent abuse of service users. At this inspection we found that policies on safeguarding vulnerable adults were available and they gave guidance to staff on how to keep people safe from avoidable harm. We also saw that staff had identification available for people to check if necessary.

Previously we had found that people’s care plan

People were supported to make decisions about the way their care and support was provided and arrangements were in place to ensure decisions were made in the best interests of people who lacked capacity.

People told us that staff had all the information they needed to support them in the right way. People said staff had provided them with all the care and support they needed with their health and wellbeing. Staff had received training in dealing with an emergency and they told us they were confident about what to do if an emergency arose.

New staff told us they had completed an induction which included training in mandatory topics and working under the supervision of more experienced staff. Staff commented that the manager was very supportive and approachable and they told us they had been given regular opportunities to discuss their work and performance.

People had been given information about how to complain and they told us they would complain if they needed to. People told us they had had no reason to complain but if they did they knew who to complain to and they said they were confident that their complaint would be listened to and dealt with in the right way.

Staff knew what their responsibilities were for ensuring people's records were properly maintained and kept safe. Records we asked for were quickly located, well maintained, up to date and kept safe. People who used the service told us that staff handled their records in the right way.

People using the service told us that staff had always been respectful towards them and that they had involved them in all aspects of their care and treatment.

People told us they had a care plan and they had a copy of it in their homes. They said their care plans included information about their care needs and how they wished them to be met. They said they were fully involved in putting together their care plan and in the reviewing of them on a regular basis. People told us that their care plans were person centred and included everything that staff needed to know about how to care and support them.

People said they had been given information about who to contact in the event of an emergency.

People said staff had treated them well and that they felt safe in their care. They said they would tell somebody if they had any concerns about the way they were treated. People said they had been given information about who to contact if they had any concerns about the way they were treated.

People told us they had been visited on a number of occasions by either the manager or a senior member of staff and they were asked their views and opinions about the service. One person commented that the manager had telephoned them regularly to make sure everything was ok.

This was an unannounced inspection carried out on 21 September 2015.  We also spoke with a number of people who used and worked for the agency on 26 October 2015.We carried out this inspection at this time due to concerns we had received from a local authority and from relatives of people using the service. These concerns related to staff not arriving on time or insufficient numbers of staff arriving to support the person.

12 Tapton Way is a domiciliary care agency registered to provide personal care to people in their own homes. The registered provider is Just One Recruitment and Training Limited. The agency office is based in Wavertree, Liverpool. At the time of this inspection they were supporting 34 people. This included adults and children, some of who had complex health needs.

The agency 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.

We last inspected 12 Tapton Way in August 2013. At that inspection we looked at the support people had received with their care, staff training, record keeping and complaints. We found that the provider had met regulations in those areas.

At this inspection we found a number of breaches relating to keeping people safe, supporting people to consent to their care, and good governance of the service.

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

The agency had not always identified and reported safeguarding incidents to the relevant authorities.

People had not always received their care as planned which had led to their safety being compromised. This had included staff not arriving to support people on time or insufficient staff arriving to meet people's planned needs.

Senior staff were aware the agency needed to improve the service they had provided and had implanted plans to address this.

Staff had been recruited safely and sufficient staff were employed to meet people's planned needs.

Staff had not always received the training they needed to support people safely and well.

The agency had not followed the law in obtaining people's consent to their planned care or ensuring decisions were taken in the person's best interests if they were unable to consent.

Records were out of date and inaccurate. This included medication records, care plans, staff training and supervision records and policies.

People received the support they needed with their health care.

People using the agency and their relatives were happy with the care staff who supported them. Staff were knowledgeable about the people they supported and had built warm relationships with people based on respect.

Senior staff were aware the agency needed to improve the service they had provided and had implemented plans to address this.