This inspection took place on the 24 November 2016 and was announced. Living Glory Social Care provides personal care to people in their own homes. At the time of the inspection eight people were using the service.

We last inspected this service in November 2015 where we identified that the registered provider had not ensured that there were complete and contemporaneous records kept regarding the care of the people who used the service and that systems were not in place to ensure compliance with the new regulations. We found that the registered provider was in breach of Regulation 17 of the Health and Social Care Act (2008) Regulations 2014, Good Governance. After that inspection the registered provider provided us with a plan of how they would ensure they met this regulation.

At this inspection we found that the provider had made some improvements and were no longer breaching regulation. However we found that further improvements were needed to ensure all records were accurate and complete.

People’s relatives told us that people received their medicines safely and we saw that staff had received training in safe medication administration. We found that further improvements were needed in the recording of medicine administration.

There is a registered manager at the service who was present throughout 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.

People using the service were unable to tell us their views of the care they received. However, we spoke with relatives to seek their views. People’s relatives told us they felt their relative was cared for well. People benefitted from support from regular staff who had got to know people well. People contributed to planning their care to say how they preferred to be supported.

People were supported by staff who were aware of the possible signs of abuse and the action to take should concerns arise.

Staff received training on people’s individual needs to ensure they could support people effectively. Improvements had been made to the support people received under the Mental Capacity Act (2005) and staff had some understanding of what this meant for people they supported.

People received support to have their nutritional and hydration needs met. Staff understood how to treat people with dignity and promote their independence.

Care was reviewed with people to ensure it continued to meet their needs. People were able to request changes to the times of calls to meet their needs.

There were systems in place for people to raise concerns or complaints should they need to.

People’s relatives and staff were happy with the way the service was managed. There were systems in place to ensure the quality of the service was monitored.

This inspection took place on 17 November 2015 and was announced. At our last inspection in June 2014 we found that the provider was not meeting the requirements of the law in relation to record keeping and we found that some records relating to people’s care were not available or detailed enough to protect people from the risk of harm. Following that inspection the provider sent us an action plan detailing the action they would take to address the breach. At this inspection we found that some improvements had been made and that the majority of records were available.

The service provides domiciliary care to 7 people in their own homes who have personal care needs. The service 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.

The registered persons advised that they were unaware of the changes introduced when the regulations changed in April 2015 and had not made any changes to ensure that checking and audit systems ensured that they were compliant with the new regulations. You can see what action we told the provider to take at the back of the full version of the report.

The people using the service were unable to tell us their views of the support they were receiving. However, we spoke to relatives to seek their views and all the relatives we spoke with were happy with the care their relative was receiving. Relatives told us that people were supported by consistent staff members who had got to know their relative well.

Staff we spoke with told us that they received sufficient training to enable them to carry out their role effectively. Staff knew how to recognise potential signs of abuse and how to raise concerns should they need to. Risks to people had been assessed and for most part measures had been put in place to reduce the risk for the person and staff.

Only staff who had been trained in medication administration were able to give medicines. We found that there was limited information available about the medicines people were taking. Although we had been informed there had been no medication errors in the last twelve months, systems were not robust enough to ensure that medications were safely administered. 

Staff had received training on the Mental Capacity Act (2005), although understanding of this legislation varied amongst staff. We found that people had been deemed as lacking capacity without the appropriate assessments taking place which meant people’s rights may not be supported in line with the legislation.

The registered manager had been responsive to people’s needs and changed the hours they supported people as requested. There was a complaints procedure in place. Relatives we spoke with had no complaints and the registered manager stated that no formal complaints had been received in the last twelve months. Where concerns had been raised the registered manager had taken appropriate action to respond to the concern promptly.

Relatives and staff we spoke with were confident in how the service was led. Staff we spoke with felt valued and supported and were able to seek advice at any time of the day.

There were systems in place to monitor the quality and safety of the service. We found that people’s care was reviewed and systems were in place to carry out checks at people’s homes. Although there had been some improvements made to people’s care plans, some peoples care plans lacked detail of their likes and dislikes and preferences of how they wanted support to be delivered.

Our inspection team was made up of one inspector who considered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that the support people received was safe. Staff we spoke with were aware of the care that people needed to keep them safe. One relative told us, “Personally I’m very pleased. I have had bad experiences with other agencies. I do feel I can trust and rely on them.”

People told us they had not recently experienced any missed calls and that care staff usually arrived on time and stayed for as long as they were expected to. One relative told us, “We’ve had no missed calls and it staggers me that the carers are never late.” A person using the service told us, “Initially there were some missed calls but not now. The carers are usually on time or ring if they are going to be late.”

Staff were recruited appropriately with checks being completed to make sure that they were safe to work with vulnerable people.

We found some staff had received training about the Mental Capacity Act and we were told that training for other staff was scheduled to take place in July. This would ensure all staff had satisfactory knowledge about any implications of the Mental Capacity Act for people they support.

We saw that the management of records needed to be improved. People were not always protected from the risks of unsafe or inappropriate care and treatment because some records relating to people's care were not available, sufficiently detailed or accurate. We have asked the provider to tell us how they will make improvements and meet the requirements of the law.

Is the service effective?

People were involved in planning their support. People and their relatives told us that they were consulted and involved in making decisions about care and support. People and their relatives had regular contact with the manager and director of Living Glory Social Care. One relative told us, “Our views are sought. The manager often telephones to check if things are okay. There is very good communication.”

We spoke to three care staff and they demonstrated a good knowledge of the needs and health conditions of the people they were providing care to. Care staff told us that care plans were retained at people's houses and were always accessible to them. They also confirmed that they tended to support the same people on a regular basis.

Is the service caring?

Care staff treated people with dignity. All the staff we spoke to referred to the people who used the service with warmth and respect. We spoke with one person using the agency and with the relatives of five people using the agency. They all confirmed that staff were polite and caring. One relative told us, “The carers are good. They have clicked with [person’s name.]

The planning of staff rotas ensured that, where possible, staff were allocated to look after the same people. People using the agency told us that they had regular staff providing their support. One person told us, “I have one main carer.” A relative told us, “I’m confident in leaving Mum as she is comfortable with the carer…The manager tries to match the carer with the person.”

Is the service responsive?

People who used the service or their representatives were asked for their views about their care and treatment and they were acted on. We found that customer satisfaction surveys were sent out regularly to people and their relatives seeking their views and feedback regarding the quality of service they received.

We saw that there were policies and procedures for dealing with complaints. We looked at the details of a concern raised and saw that appropriate action had been taken to reduce the risk of further occurrences.

We found evidence to show that learning from incidents took place. We had previously been informed of an incident of poor staff practice resulting in a safeguard referral being made to the local authority. We found that actions had been taken to address the concerns.

Is the service well-led?

A schedule of individual and group staff meetings was in place to help ensure staff received the support they needed for their role. All of the staff we spoke with told us they felt well supported and that they had regular contact and checks from the manager or director to discuss how they were getting on.

There were arrangements for staff to raise concerns. The manager told us that she welcomed suggestions and comments from staff. The staff who we consulted told us that they found the manager and the director easy to talk to. One care staff told us, “The managers are very approachable. I’m confident to raise any issues, they do listen.” This member of staff gave us an example of something they had raised previously which had been responded to appropriately.

We visited the agency's offices in Birmingham and spoke with the registered manager and the director of strategy and planning.

Following our visit, we spoke with one person using the service, the relatives of four people and with six members of staff.

All of the people we spoke with confirmed they were happy with the service they received and had no concerns or complaints about the agency. A person using the service told us, ‘’The care is excellent, rest assured they do an excellent job.’’

During the inspection we looked at three people's care records. It was not evident that care was always planned in a way that ensured people's safety and welfare.

Staff demonstrated a good awareness of the procedures they would follow if they suspected abuse.

We were unable to evidence that the agency had followed robust recruitment procedures before staff started working with people or had all the training they needed. This meant the provider could not fully demonstrate that some staff were suitable to work with vulnerable people.

The agency had some systems to monitor the quality of the service provided but these needed improvement to make sure they were effective.

During our review, we discussed the quality of the service provided by the agency with local authority staff involved in monitoring them. They did not raise any current concerns about the agency with us.