MBI Home Care is a domiciliary care agency which provides personal care to people in their own homes. At the time of our inspection the agency supported approximately 66 people with personal care and employed 42 care staff.

Following our last comprehensive inspection of the service in August 2015 we rated the service ‘Requires Improvement’. This was because the provider was not providing the standard of service we would expect in two key areas, responsive and well led. During our comprehensive inspection in February 2017 we found improvements had been made, but further improvement was required for the service to be consistently responsive.

We visited the offices of MBI Home Care on 9 February 2017. We told the provider 48 hours before the visit we were coming so they could arrange to be there and for staff to be available to talk with us about the service.

A requirement of the provider’s registration is that they have a registered manager. There was a registered manager in post at the time of 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 and associated Regulations about how the service is run. The registered manager was also the provider of the service.

People told us they felt safe using the service and staff understood how to protect people from abuse and keep people safe. There were processes to minimise risks to people’s safety. These included procedures to manage identified risks with people’s care and for managing people’s medicines safely. The character and suitability of staff was checked during recruitment procedures to make sure, as far as possible, they were safe to work with people who used the service.

There were enough staff to deliver the care and support people required. Staff received an induction when they started working for the service and completed regular training to support them in meeting people’s needs effectively. People told us staff had the right skills to provide the care and support they required.

The managers and staff followed the principles of the Mental Capacity Act (MCA). Staff respected decisions people made about their care and gained people’s consent before they provided personal care.

People had different experiences with the times staff arrived to provide their care. Some people said staff arrived around the time expected; others had experienced late or missed calls. The provider used an electronic system for staff to log in and out of people’s homes; this system did not alert office staff if care staff had not arrived at people’s homes at the expected time.

People told us staff stayed long enough to provide the care they required. Most people said they received care from staff they knew. Staff we spoke with visited the same people regularly and knew how people liked their care delivered. Care plans provided guidance for staff about people’s care needs and instructions of what they needed to do on each call. Where people required support, staff made sure people had enough to eat and drink and were referred to healthcare services when required.

People told us staff were kind, respected their privacy, and promoted their independence. Staff felt supported to do their work effectively and said the managers were approachable and knowledgeable. There was an ‘out of hours’ on call system, which ensured management support and advice was always available for staff.

People knew how to complain if they needed to. People and staff said they could raise any concerns or issues with the managers, although some people felt they were not always listened to by the registered manager.

Quality assurance systems were in place to assess and monitor the quality of the service. These included asking people for their views about the service through telepho

MBI Homecare is a domiciliary care agency which provides personal support to people in their own homes. At the time of our visit the agency provided a service to 70 people.

We visited the office of MBI Homecare on 6 August 2015. The provider was given 48 hours’ notice that we were coming. This was to make sure they would be there and so they could arrange for care workers to be available to talk with us about the service.

The service has 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 manager was also the provider for the service.

People and their relatives told us they felt safe using the service. Care workers were trained in safeguarding adults and understood how to protect them from abuse. There were processes to minimise risks associated with people’s care to keep them safe. This included the completion of risk assessments and checks on care workers to ensure their suitability to work with people who used the service.

Managers and care workers understood the principles of the Mental Capacity Act 2005 (MCA) and people were asked for their consent before care was provided. Most people told us staff had the right skills and experience to provide the care and support they required.

People told us care workers respected their privacy and were kind and caring. There were enough suitably trained care staff to deliver care and support to people. However, people had different experiences about the service they received. Some people had regular care workers who arrived on time, other people had to wait over the agreed time. Some people told us they had difficulty communicating with their care workers as their ability to speak or understand English was limited.

Care plans and risk assessments contained relevant information for staff to help them provide the personalised care people required. The provider was unable to confirm that care workers carried out people’s care as recorded in their care plans. This was because records made during care calls were not regularly checked to confirm this.

Most people knew how to complain and information about making a complaint was available for people. Most people said they were confident about raising complaints and knew who to contact if they had any concerns. Staff said they could raise any concerns or issues with the managers, knowing they would be listened to and acted upon.

There were processes to monitor the quality of the service provided and to understand the experiences of people who used the service. This was through communication with people and staff, checks on medication records, returned surveys and a programme of checks and audits. However, these systems were not consistently identifying that people were not receiving the quality of care and services they expected.