This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. It provides a service to older adults and younger disabled adults. There were five people using the service at the time of our inspection. The service also provided care staff to residential care homes although we did not inspect this part of the service as it is not part of our regulatory remit to do so.

We inspected New Dawn Recruitment Agency on 5 October 2018. The inspection was announced 48 hours in advance because we needed to ensure the provider or registered manager was available.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run. However, the registered manager was no longer in day to day charge of the service. The care manager who oversaw the service told us they would soon register with CQC.

Risks relating to people’s care were reduced as the provider followed suitable risk assessments processes. Risks relating to infection control and medicines management were also managed appropriately. Staff knew how to respond to abuse to protect people and they received training in this.

People were cared for by the right number of staff needed to keep them safe. Staff were recruited through recruitment processes which checked they were suitable.

Care plans were up to date and reliable in guiding staff on the best ways to care for people. People were involved in their care plans.

Staff received the right support with training to understand people’s needs and supervision. People received food and drink of their choice. Staff supported people with their day to day health needs.

People received care in line with the Mental Capacity Act 2005 and received choice in relation to their care.

People were positive about the staff who supported them and the care they received. The provider had systems to gather feedback from people and staff and make improvements. People had confidence the provider would respond in the right way to any concerns or complaints.

The service was well-led with visible leadership. The care manager and staff understood their roles and responsibilities. Systems to assess and monitor the quality of care people received remained suitable.

We inspected Lombard Business Park on 25 January 2016. The inspection was announced 48 hours in advance because we needed to ensure the provider or registered manager was available.

Lombard Business Park is a service which provides personal care to adults in their own home. At the time of our visit there were seven people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

We previously inspected Lombard Business Park in July 2015. We found the provider was not meeting all the legal requirements and regulations we inspected. We found there were inadequate arrangements in place for people to receive their medicines safely, people were not protected from avoidable harm and did not receive personalised care. There was also a lack of effective management at the service. We asked the provider to take action to make improvements. The provider sent us an action plan and this action has now been completed.

During this inspection we found that there were arrangements in place to protect people from abuse which staff were aware of. Staff had received safeguarding training. They had good knowledge about how to identify abuse and how to report any concerns.

Care was planned and delivered to ensure people were protected against foreseeable harm. People had risk assessments which were personalised and identified a variety of risks. The risk assessments gave staff sufficient information on how to manage the risks identified.

Staff arrived on time and stayed for the time allocated. People were cared for by a sufficient number of suitable staff to keep them safe and meet their needs. Staff were recruited using an effective procedure which was consistently applied. Staff controlled the risk and spread of infection by following the service’s infection control policy.

There were appropriate arrangements in place to ensure people received their medicines safely. Care plans provided information for staff about how to meet people’s individual needs.

Staff had relevant training and experience to deliver care effectively. Staff supported people to have a sufficient amount to eat and drink. Staff worked with a variety of healthcare professionals to support people to maintain good health.

Staff understood the relevant requirements of the Mental Capacity Act 2005 and how it applied to people in their care. People were given choice and felt in control of the care they received.

Staff were kind, caring and treated people with respect. People were satisfied with the quality of care they received. People were supported to express their views and give feedback on the care they received. The provider listened to and learned from people’s experiences to improve the service.

Staff understood their roles and responsibilities. People felt able to contact the service’s office to make a complaint and discuss their care. There were systems in place to assess and monitor the quality of care people received.

We inspected Lombard Business Park on 29 July 2015. The inspection was announced 48 hours in advance because we needed to ensure the provider or registered manager was available.

Lombard Business Park is a service which provides personal care to adults in their own home. At the time of our visit there were 13 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

We previously inspected Lombard Business Park in May 2014. We found the provider was meeting all the legal requirements and regulations we inspected.

During our inspection in July 2015 we found that there were arrangements in place to protect people from abuse which staff were aware of. Staff had received safeguarding training and had good knowledge about how to identify abuse or report any concerns.

Care was not always planned and delivered to ensure people were protected against foreseeable harm. People had risk assessments but they did not identify obvious risks or give staff sufficient information on how to manage the risks identified.

Staff arrived on time and stayed for the time allocated. People were cared for by a sufficient number of suitable staff to keep them safe and meet their needs. Staff were recruited using an effective procedure which was consistently applied. Staff controlled the risk and spread of infection by following the service’s infection control policy.

There were not appropriate arrangements in place to ensure people received their medicines safely. Care plans provided information to staff about how to meet people’s individual needs. However, the information was not always sufficiently detailed to enable staff to safely support people they did not know well.

Staff had the skills and experience to deliver care effectively. Staff supported people to have a sufficient amount to eat and drink. Staff worked with a variety of healthcare professionals to support people to maintain good health.

Staff understood the relevant requirements of the Mental Capacity Act 2005 and how it applied to people in their care. People were given choice and felt in control of the care they received.

Staff were kind, caring and treated people with respect. People were satisfied with the quality of care they received but told us there could be greater continuity of care. People were supported to express their views and give feedback on the care they received. The provider listened to and learned from people’s experiences to improve the service.

Staff understood their roles and responsibilities. People felt able to contact the service’s office to make a complaint and discuss their care. There were systems in place to assess and monitor the quality of care people received.

There was a staff structure in place but some staff did not know the registered manager. Staff told us they were supported by the care co-ordinator. The care co-ordinator was given the responsibility of overseeing the day-to-day care people received but was not adequately supported by the registered manager to do so effectively.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the arrangements in place for people to receive their medicines safely, how the provider protected people from avoidable harm, provided personalised care and managed the service. You can see what action we told the provider to take at the back of the full version of this report.

The inspection was conducted by an inspector who gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service safe? Is the service caring? Is the service effective? Is the service responsive? Is the service well led?

During the inspection we reviewed six people's care files, spoke with four people using the service, people's representatives and members of staff. We also reviewed policies and records relating to people using the service, staff and management of the service.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe. One person told us, “I definitely feel safe and if I didn't I'd be straight on the phone." There were policies and procedures in place to minimise the risk of people being abused and staff knew the action to take if they suspected a person using the service was at risk of abuse. Proof of identity was required and criminal record checks were conducted before staff were allowed to work with people. Staff had received training in safeguarding vulnerable adults and in the main principles of the Mental Capacity Act 2005.

People's needs were adequately assessed and care and treatment was appropriately planned to ensure people's safety. Risk assessments were conducted which identified risks and gave care staff information on how to manage the identified risks. We found that staff received appropriate training, supervision and professional development to do their job safely and to an appropriate standard.

Is the service caring?

We spoke with four people who use the service about the staff who cared for them and the quality of care. People said the staff were caring. Comments we received included, “X is kind and caring. I'm completely comfortable with her." “The carers are very good" and “The carers are very good, very willing."

Staff we spoke with were all experienced carers who told us they knew the needs of the people they cared for and enjoyed caring them. People told us they were contacted regularly by one of the managers to find out if they were happy with their care.

Is the service effective?

People's needs were appropriately assessed and reviewed. The care plans and risk assessments we looked at were personalised and reflected people's individual needs. People thought that staff had the necessary skills and experience to do their job and that they did their job well.

People who used the service were satisfied with the way their care was delivered. Comments we received included, “I'm happy with the service. I've had the same carer for over two years, she knows what I need and just gets on with it." “They arrive on time and know what they are doing." We also spoke to people's representatives and their comments about the service were positive.

Is the service responsive?

The care plans we reviewed reflected people's assessed needs. As well as people's medical and personal care needs, people's care assessments considered a variety of other needs. For example, people using the service were asked to complete a cultural and religious questionnaire so that their dietary requirements, religious and cultural needs could be taken into account in their care planning.

People using the service were given information on who to contact if they wanted to make a complaint or comment about the care they received. People were confident that any concerns they had regarding their care would be dealt with appropriately. Staff told us that every person using the service had been visited since our last inspection to have their care needs reviewed. We saw confirmation of this in all of the care files we looked at. Staff told us care plans would be reviewed every six months or when they were aware of a change in a person's need.

Is the service well-led?

Several new systems had been implemented since our last inspection which had improved the management of the service. Management met regularly with staff and staff were appropriately trained and supported through supervision and appraisal. Staff told us they felt supported by the management team in relation to their responsibilities.

Senior staff had regular contact with people using the service to get their feedback. Staff rotas were organised so as to ensure people were regularly cared for by the same staff who knew and understood their needs. There were systems in place to check staff arrived on time and delivered the care people had requested as set out in their care plan.

People were involved in their care planning and their privacy and dignity was respected by the carers. People told us, “They do what I ask them to do and they do it how I ask them to.” “The carers are quite flexible and if I say I don’t want a bath until the afternoon visit, that’s when they will give me a bath.”

People and their representatives were satisfied with the quality of care. Comments we received included, “The carers look after me properly.” "I feel quite comfortable with them. I'm happy with them." A representative told us “The carers are excellent. They turn up on time, they are courteous, they look after X well."

However, we were concerned that people's needs were not re-assessed once they started to use the service. We were also concerned that care was not always planned to ensure people's safety and welfare because risk assessments were not always carried out and the risk assessments we saw were inadequate.

We found that people who use the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

There were effective recruitment procedures in place and appropriate checks were carried out before staff began to work with people using the service. However, we were concerned that staff were not adequately supported by the service because they did not receive appropriate professional development, supervision or appraisal.