This was a comprehensive inspection which took place on 11and 12 December 2017 and was announced. We gave the manager 48 hours' notice because the location provides a domiciliary care service and we needed to make sure someone would be in the office to assist us.

Lifecarers (Bracknell, Crowthorne and Sandhurst) Ltd. is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, younger disabled adults, people living with dementia and people with disabilities. The Care Quality Commission (CQC) only inspects the service being received by people provided with the regulated activity ‘personal care’; help with tasks related to personal hygiene and eating. Not everyone using Lifecarers (Bracknell, Crowthorne and Sandhurst) Ltd. receives the regulated activity. Where they do we also take into account any wider social care provided.

The service did not have a registered manager as required, however, a manager had been appointed and had begun the process of applying to be registered. A registered manager is a person who has registered with the CQC 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. The manager was present and assisted us during the inspection.

At the last inspection the service was rated Good. At this inspection we found the service remained Good overall but they required improvement in Safe.

Risks associated with people’s health and the care they received were assessed. However, guidance for staff on how to minimise the risks was not always sufficiently detailed. This was mitigated by the good communication and information sharing between staff. Accidents and incidents were recorded but it was not clear what investigation had taken place and how lessons learnt were shared from these. Following the inspection the manager sent us evidence of how they were addressing these issues.

People told us they felt safe with the care staff, while relatives confirmed they felt confident their family members were cared for safely. Robust recruitment procedures were followed to ensure as far as possible only suitable staff were employed. Staff were trained to safeguard and protect people. They reported concerns promptly when necessary. People received their medicines safely when they required them.

People continued to receive effective care from staff who were trained and had the necessary skills to fulfil their role. Staff felt supported by one to one meetings supervision meetings, annual appraisals and staff meetings. These all provided them with time to seek advice, discuss and review their work. They had opportunities to develop their skills and knowledge as well as gain relevant qualifications. The service worked well with other teams of professionals to provide effective care for people.

When required people were supported with nutrition and hydration. People’s healthcare needs were monitored and advice was sought from healthcare professionals when necessary. People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

People reported staff were kind and patient. People’s privacy and dignity were protected, they told us staff treated them with respect. People and when appropriate relatives were involved in making decisions about their care.

The service was responsive to people’s individual needs. Staff knew people well and individual care plans were person-centred. They focused on the diverse needs and preferences of each person along with their desired outcomes. People’s views were sought and they knew how to raise concerns or make a complaint if necessary. We have made a recommendation that the provider rev