Link Medical Staffing Solutions is domiciliary care agency. This service provides personal care to people living in their own homes. It provides a service to adults who may be living with dementia, a physical disability and/or mental health conditions. At the time of our visit there were 12 people using the service. This inspection took place on 12 June, 15 June and 2 July 2018 and was announced. We gave the provider just under 24 hours’ notice. Because the provider is based from an office, we needed to be sure someone would be available to meet with us.

There was a registered manager in post at the time of our inspection. The registered manager was also the owner of the provider company. We have referred to this person as the ‘provider’ throughout this report. A registered manager is a person who has registered with the Care Quality Commission (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.

This was the service's first inspection. The provider first registered with CQC in September 2017. This inspection was brought forward due to a number of concerns we received about the service. At this inspection, the service was rated requires improvement overall. We found they were in breach of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider had failed to implement a quality monitoring system to ensure the agency

functioned safely and effectively. This meant they were not aware of issues such as inconsistencies with recruitment practice. The lack of effective audits also meant the provider had not identified a wide range of records relating to people's needs were missing from the service. The provider's governance arrangements had failed to identify when things had gone wrong and take action to put this right.

Recruitment measures were not robust in contributing to protecting people from unsuitable staff being employed. The provider had failed to monitor the quality and safety of the service, including spot checks of staff practice, supervisions and audits of care records.

Staff did not have sufficient formal opportunities to discuss their performance or their training and development needs.

Care plans were not all reflective of people’s current support needs; the information within them was not always detailed.

People knew how to raise complaints and concerns however complaints were not compiled to show how the service had analysed and responded to information gathered or used this information to make improvements to the service.

People who used the service and their relatives spoke highly about staff and told us they were caring. They said staff were respectful at all times and they were encouraged to remain independent.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment and good governance. You can see what action we told the provider to take at the back of the full version of the report.