Leda Homecare provides personal care and support for people in their own homes in Worksop, Nottinghamshire. We carried out this inspection on 17 July 2017. It was an announced inspection, which meant the provider knew we would be visiting. This was because we wanted to make sure the registered manager, or someone who could act on their behalf, would be available to talk with us. On the day of the inspection there were approximately 100 people using the service.

At our last inspection on 28 July 2016 the service was rated as Requires Improvement overall. We found medicines were not consistently managed safely as staff did not always have all the information they needed and did not always keep accurate records. There were no formal systems in place for auditing the overall quality of the service. Where people lacked the mental capacity to make certain decisions the service did not always work in accordance with the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests. This was a breach of regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to send us an action plan detailing how they would address the identified shortfalls, which they did. At this inspection we found the necessary improvements had been made and the service was no longer in breach.

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.

Staff were appropriately recruited, trained and supported. They had undergone a comprehensive induction programme and, where necessary, had received additional training specific to the needs of the people they were supporting. Communication was effective and regular meetings were held to discuss issues and share best practice. Staff understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for.

Since the previous inspection the provider had implemented detailed policies and procedures relating to medicines management. Staff understanding and competency regarding the management of medicines was subject to regular monitoring checks and medicines training was updated appropriately.

Staff knew the people they were supporting and provided a personalised service and used effective systems for gaining consent. Individual care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner. Risk assessments were also in place to effectively identify and manage potential risks.

Systems, implemented since the previous inspection, were in place to effectively monitor the safety and quality of the service and to gather the views and experiences of people and their relatives. The service was flexible and responded positively to people’s changing needs and any issues or concerns raised. People and their relatives told us they were confident that any concerns they might have would be listened to, taken seriously and acted upon.

This announced inspection was carried out on 28 July 2016. Leda Homecare provides support and personal care in Nottinghamshire. On the day of the inspection there were approximately 100 people using the service who received personal care.

The service had a registered manager in place at the time of our inspection. 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 found that medicines were not always managed safely as staff did not always have all the information they needed and did not always keep accurate records.

People were supported by staff who knew how to recognise and respond to abuse and systems were in place to minimise the risk of harm. Risks associated with people’s care and support were effectively assessed and managed.

People had access to healthcare and people’s health needs were monitored and responded to. People were supported to eat and drink enough.

People were supported by staff who had the knowledge and skills to provide safe and appropriate care and support. There were sufficient numbers of staff available to meet people’s needs. Safe recruitment practices were followed and staff were provided with regular supervision and support.

Where a person lacked capacity to make certain decisions their rights under the Mental Capacity Act 2005 were not protected.

People who had capacity to make decisions were enabled to make choices about their support and were asked for their consent by staff providing care. People were encouraged to be as independent as possible.

Staff were kind and compassionate and treated people with respect. People’s rights to privacy and dignity were promoted and upheld. People were supported to raise issues and staff knew how to deal with concerns if they were raised.

People and their families were involved in planning their care and support and staff knew people’s individual preferences. People using the service and staff were involved in giving their views on how the service was run.

There were no formal governance systems in place to check the overall quality of the service. However, there were informal processes in place to monitor day to day aspects of service delivery.

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

During this inspection we conducted a telephone interview with people who used the service and relatives. We spoke with staff including; care co-ordinators, care workers, the registered manager and director. We reviewed five care plans and looked at four staff files. We reviewed company policies and other records relevant to the management of the service.

People were involved with decisions relating to their care and support and their independence was encouraged. A person who used the service told us, "I’ve been involved right from the start, this company is absolutely smashing.”

The provider ensured people's needs were met and their care provided in an effective way. A person who used the service told us, “They (care workers) really look after me well, they’re lovely girls.”

People were protected from the risk of abuse. A relative we spoke with told us, “We trust them (staff), I know we have to but you can tell that they love what they do.”

Staff received appropriate training and the quality of their work was regularly assessed. A care coordinator we spoke with told us, “I have completed a lot of training in a number of areas. I am always happy to learn. The management are always happy to support us to progress. Staff here get a lot more training than in other organisations I have worked for.”

There were systems in place to monitor the quality of the service people received. The service was well led by the registered manager and director.