We carried out this announced inspection on 7 December 2016.

Namron Care Provider Ltd provides personal care and support for people in their own homes. At the time of our inspection the service was providing personal care support for 16 people in the city of Lincoln and its surrounding villages.

The service is owned and operated by a company and run by three directors, one of whom was the registered manager. They were involved in the day to day running of the service. 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 person or persons’.

Staff knew how to respond to any concerns that might arise so that people were kept safe from harm. People had been helped to avoid the risk of accidents and the arrangements in place to support people with their medicines were managed safely. There were enough staff employed by the service to carry out the visits they needed to undertake. Background checks had been completed for new staff to make sure they were appropriate to work with people who the service cared for.

Staff had received training and guidance and they knew how to support people with the care assessed as needed. People had been assisted to eat and drink enough and they had been supported to receive all of the healthcare assistance they needed. Staff were supported to speak out if they had any concerns and good team work was promoted by the registered persons.

People were treated with kindness and compassion. Staff recognised people’s right to privacy and promoted their dignity. Confidential information was kept private.

CQC is required by law to monitor how registered persons apply the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had received training in this subject and this enabled them to help people make decisions for themselves. When people lacked the capacity to make their own decisions the principles of the Mental Capacity Act 2005 and codes of practice were followed. This helped to protect people’s rights by ensuring decisions were made that were in their best interests.

People had been consulted about the care they wanted and needed to receive and staff worked together with people and relatives who were involved in their care.

Some quality checks had not been consistently completed to make sure that people reliably received all of the care they needed. Arrangements for receiving people’s feedback were in place but not robustly managed.

We previously carried out an announced comprehensive inspection of this service on 12, 13 and 14 May 2015. During this inspection we found that the provider was not meeting the standards we expected and there was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the systems in place to assess and monitor the quality of the service were not effective.

After the inspection, the registered provider wrote to us to say what they would do to meet the legal requirements in relation to the breach.

We undertook this focused inspection on 28 January 2016 in order to check that the registered provider had followed and completed their plan and to confirm that they now met the legal requirements. During this inspection we found the provider had made improvements in the specific areas we had identified.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Namron Care Provider Ltd on our website at www.cqc.org.uk

Namron Care Provider Ltd provides care for people in their own homes. At the time of our inspection the service was providing care for four people and covered the geographical areas of the city of Lincoln and its surrounding villages.

There was a registered manager in post who was also the registered provider of the service. For the purpose of this report we refer to the registered manager as the provider. 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.

On the day of our inspection we found that the existing arrangements in place to monitor the quality of the service had been strengthened in order to keep improving the quality of care people received. Audits were in place to check the work being completed by staff. These checks were more effective in identifying and quickly responding to issues they identified at an earlier stage.

This was an announced inspection carried out over three visits made on 12,13 and 14 May 2015.

There was a registered manager in post who was also the provider of the service. 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.

Namron Care Provider Ltd provides care for people in their own homes. At the time of our inspection the service was providing care for 32 people and covered a 20 mile radius around the city of Lincoln and its surrounding villages.

During our inspection we found there was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the systems in place to monitor the quality of the service were not effective. Although individual complaints had been investigated and quality checks had been completed they had previously not effectively identified and resolved these problems. You can see what action we told the registered persons to take at the back of the full version of this report.

Staff were caring and positive relationships had been developed between people and staff. Staff understood the Mental Capacity Act 2005 and people told us staff asked for permission before providing support to them. Staff treated people with respect and helped them maintain their dignity and people were supported by staff to make their own decisions and choices.

The registered provider had information about how people could access independent advocacy services and staff were aware of their responsibilities relating to confidentiality.

Staff had completed safeguarding training and had access to guidance. They were able to recognise if people were at risk and knew what action they should take. The registered provider had taken action when people had been identified as at risk. However, their approach to identifying, recording and managing risk was inconsistent.

The registered provider completed appropriate pre-employment checks before any new staff member started to work for the service. Staff received an induction when they started employment with the provider. Staff were sufficiently trained and supported by the registered provider to undertake their roles and there was sufficient staff to provide people’s care. However, the staff providing care to people was not always consistent with their timings and available when people required care.