The inspection took place on 9 and 10 January 2019. The inspection was announced. This meant the registered provider was given 48 hours' notice of our inspection visit. This was because the location provides a small domiciliary care service and we needed to be sure that someone would be available to meet with us.

Lotus Homecare (Sheffield) is registered to provide personal care to adults with a range of health and social care needs. This was our first inspection of Lotus Homecare (Sheffield) under the registered provider's registration with the Care Quality Commission (CQC).

At the time of the inspection Lotus Homecare (Sheffield) were supporting 70 people with the regulated activity.

There was a manager at the service who was registered with CQC. A registered manager is a person who has registered with 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 and associated Regulations about how the service is run.

People raised concerns about the consistency of the staff that supported them. Some people spoke very positively and told us they felt safe and their care workers were respectful and kind. Where people did not have regular care staff they told us they did not always feel safe, because the care staff did not know their care needs as well as the regular staff. We shared specific concerns with the registered manager who took immediate action to resolve these concerns and improve people's experience.

We found there were systems in place to protect people from the risk of harm. Staff we spoke with could explain the procedures to follow should an allegation of abuse be made. Although there were a couple of examples where staff were not consistently following the providers procedures. The registered manager was aware of this and had addressed these concerns through direct supervision.

We found systems were in place to administer people's medicines safely. The service adhered to the local authority policy for the safe administration of medicines. Systems were monitored and any errors were reported and acted on to prevent reoccurrence.

Assessments identified risks to people, and these were regularly reviewed to ensure people's safety.

Staff were provided with relevant training and supervision to make sure they had the right skills and knowledge to support people. Some staff said they would benefit from additional training in safeguarding vulnerable adults and catheter care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider's policies and systems supported this practice. People had consented to receiving care and support from Lotus Homecare (Sheffield).

People were supported to maintain a healthy diet, which considered their culture, needs and preferences, so their health was promoted and choices could be respected.

Some people felt complaining did not improve the service they received as any concerns they raised weren’t responded to or acted upon. People told us they did not always get a response when they telephoned the agency office.

Systems were in place where managers monitored and reviewed the quality of the service provided to people. However, we found that these systems needed further embedding to ensure continuous improvement of the services provided.