We carried out an announced inspection of the service on 22 August 2018 and 3 September 2018. LJM Homecare is a domiciliary care agency. It provides personal care to people living in their own homes. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

There was a registered manager 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

This was the first comprehensive inspection for this location.

A process for quality checking was in place but this had not identified some of the issues we found at inspection. There were enough staff on duty, however there were occasions when staff did not have sufficient time between calls to ensure they arrived at people’s homes on time. People told us that they received person-centred care according to their wishes.

There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their independence was respected. Medicines were managed safely. There were sufficient staff to safely meet people’s needs. However, support was not consistently provided at the times people expected. Background checks had been completed before new staff had been appointed.

Arrangements to prevent and control infection were in place. Action had been taken when things had gone wrong to prevent the risk of them reoccurring.

Staff had been supported to deliver care in line with current best practice guidance. However, records were not consistently clear about people’s ability to consent to care.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice.

People were helped to eat and drink enough to maintain a balanced diet. People were supported to access healthcare services so that they received on-going healthcare support.

People were treated with kindness, respect and compassion. They had also been supported to express their views and be actively involved in making decisions about their care. In addition, confidential information was kept private.

Information was provided to people in an accessible manner. The registered manager recognised the importance of promoting equality and diversity. People’s concerns and complaints were listened and responded to improve the quality of care. Arrangements had been made to support people at the end of their life.

There was a registered manager who promoted a positive culture in the service that was focused upon achieving good outcomes for people. They had also taken steps to enable the service to meet regulatory requirements. Staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. The provider had put in place arrangements that were designed to enable the service to learn, innovate and ensure its sustainability. There were arrangements for working in partnership with other agencies to support the development of joined-up care.

Further information is in the detailed findings below.