Lynx Care (UK) Ltd is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community, some of whom have complex needs and require 24-hour support. At the time of this inspection, 37 people were receiving support and 40 support workers were employed. The service office is based in the S9 area of Sheffield, close to transport links.

There was a manager at the service who was registered with the Care Quality Commission (CQC). 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 and associated Regulations about how the service is run.

Our last inspection at Lynx Care (UK) Ltd Homecare took place on 31 January and 1st February 2017. We found four breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches of Regulation 12: Safe care and treatment, Regulation 17: Good governance, Regulation 18: Staffing and Regulation 19: Fit and proper persons employed.

Following the last inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve the key questions asking if the service was safe, effective and well led, to at least good.

This inspection took place on 12 and 13 February 2018 and was announced. We gave the registered manager 48 hours’ notice of our inspection to make sure the registered manager, some staff and some people receiving support would be available to meet and speak with us.

At this inspection, we found sufficient improvements had been made to meet the requirements of Regulation 12: Safe care and treatment, as medicines administration procedures were adhered to and the medicines administration records seen had been fully completed. In addition, individual’s risk assessments had been dated and reviewed to make sure they were relevant and up to date.

We found sufficient improvements had been made to meet the requirements of Regulation 17: Good governance, as systems were in place to effectively monitor and improve the quality and safety of the service.

We found sufficient improvements had been made to meet the requirements of Regulation 18: Staffing, as staff were provided with relevant training, supervision and appraisal for development and support.

We found sufficient improvements had been made to meet the requirements of Regulation 19: Fit and proper persons employed, as the recruitment files checked contained full and relevant information.

People spoke very positively about the support provided to them. They told us they felt safe and their support workers were respectful and kind. People told us they received a consistent and reliable service that met their needs.

We found there were systems in place to protect people from the risk of harm. Staff we spoke with were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified risks to people, and management plans to reduce the risks were in place to ensure people's safety.

There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service.

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 Lynx Care (UK) Ltd.

Visit times were flexible to support people’s needs and enable them to access health and social care professionals to help maintain their health and wellbeing.

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

Staff knew the people they supported well. People’s privacy an

We undertook an announced inspection of Lynx Care (UK) Ltd on 24 and 25 January 2017. We told the registered manager two days before our visit that we would be coming because the location provides a domiciliary care service and we wanted to ensure the registered manager was available.

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

Our inspection was discussed and arranged with the registered manager two days in advance. This was to ensure we had time to visit and contact people who used the service and speak with the registered manager and staff.

People told us they felt safe with the support they received from Lynx Care (UK) Ltd.

We found people were not fully protected against the risks associated with medicines because the registered provider and registered manager did not have appropriate arrangements in place to manage medicines.

Although the registered provider had a policy and procedure in place for the safe recruitment of staff we found gaps in the information required prior to people being offered a position at the service. This was because full previous employment history was not provided by all staff before they were offered a position at the service.

Although staff told us they felt supported by the registered manager we found staff were not provided with a regular programme of training, supervision and appraisal. This meant they may not have the latest knowledge and skills in key topics needed to deliver effective care.

There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were able to accommodate changes to visits as requested by the person who used the service or their relatives.

The registered provider had systems in place to manage risks and safeguarding matters.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and the principles of the Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

People were supported to eat and drink. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

People told us their care workers were, “Kind” and “Lovely.” People had developed positive relationships with their regular care workers and enjoyed the time they spent with them.

People told us they could talk to their care workers and the office staff at Lynx Care (UK) Ltd. They said if they had any concerns or worries they were confident staff would listen to them and look at ways of resolving their issues.

Staff supported people to maintain their independence and continue to join in with social activities and hobbies that they enjoyed.

The registered provider and registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot checks and care reviews. We found these had not been effective in ensuring compliance with regulations and identifying areas requiring improvement and acting on them.

We found four breaches in the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in regulation12: Safe care and treatment, regulation 19: Fit and proper persons employed, regulation 18: Staffing and regulation 17: Good governance.

You can see what action we told the provider to take at the back of the full version of the report.