This inspection took place on 17 January 2018 and was announced. At our last comprehensive inspection in November 2016 the service was in breach of four legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were Regulation 12, Safe care and treatment; Regulation 18, Staffing; Regulation 19, Fit and proper persons employed; and Regulation 17, Good Governance.

Following the comprehensive inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of ‘Safe’, ‘Effective’ and ‘Well-Led’ to at least ‘good’. In January 2017 we went back to the service to do a ‘focused’ inspection to check people who used the service were safe. We saw at the focused inspection improvements had started to take place. During this inspection we found the service had continued to improve and there were no longer any breaches in the Regulations.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of our visit it provided care to 11 adults. We spoke with two people and seven relations.

The service had 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 service provided care to a much smaller group of people than during our last comprehensive inspection visit, and with a reduced number of staff working at the service. There was a new office team and management structure. The office and management team were clear about their roles and responsibilities and worked well together to improve the service provided to people. Staff told us they enjoyed working for the service, and felt supported by the office and management staff.

Management had reflected on where they had gone wrong in the past, and had put measures in place to make sure they identified issues quickly so they could be rectified at an early stage.

Care records had improved since our last inspection. They now provided staff with clear information about the risks related to people’s care and how they could best minimise these when delivering support to people. People’s care needs were regularly reviewed, and the office was in regular contact with people or their relatives to check care provided was what people wanted and expected. Most people felt the office and management team listened to them and dealt with any concerns they had.

Most people and relatives of people who used the service told us they received care from staff who were kind, friendly and knew how to support them. People’s dignity and privacy was respected by the staff who supported them. Food and drink was provided in line with people’s requests.

Most people told us care workers arrived at the time expected, and undertook the care tasks as outlined in their care plan.

People felt safe with the care workers who supported them. Recruitment practice had improved since our last visit, and now all pre-employment checks had been carried out before staff started to work for the service.

Care workers understood the Mental Capacity Act, and the importance of gaining people’s consent before delivering care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff made sure they used protective clothing when proving personal care to reduce the risk of infection being passed from one person to another.

People who were supported with medicines, received their medicines from staff who had been trained to administer them. Medicine records had improved since our last inspect

We carried out an announced comprehensive inspection of this service on 17 November 2016. Breaches of the legal requirements were found. One of the breaches was because the provider's recruitment process had not always been followed to ensure staff were checked thoroughly before they started to work for the service. This meant they breached Regulation 19 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Fit and proper persons employed).

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

Since the comprehensive inspection we received further information alleging that staff had started working for the organisation before the relevant suitability checks had been carried out. We also received concerns that there were not enough staff to support people's calls safely. We undertook a focused inspection to look into these concerns.

This report only covers our findings in relation to this topic. At the time of our visit, the service supported 23 people and employed eight care staff.

We found the provider had carried out appropriate checks on staff who worked for the service. The provider told us some staff had left the service since our comprehensive inspection. New staff had been recruited but they had not yet started to work for the service because the provider was waiting for their references and clearances to be returned.

We found the provider had voluntarily agreed not to accept any new people funded by the local authority, and had not started working with any new privately funded people to ensure there were enough staff to meet people's needs.

People and staff we spoke with told us staff arrived at their homes at the expected time and stayed the agreed length of time to undertake their care tasks. Staff told us they had enough time to travel between care calls and they did not feel rushed when undertaking care.

Some of the people we spoke with felt there had been an improvement since our last inspection.

We found the provider was working to improve the service and in line with the set of actions they sent us after our comprehensive inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘New Hope Care Coventry on our website at www.cqc.org.uk’

New Hope Care Coventry is a domiciliary care agency which is registered to provide personal care support to people in their own homes. At the time of our visit the agency supported approximately 49 people with personal care and employed 14 care workers.

We visited the offices of New Hope Care Coventry on 17 November 2016. We had told the provider 48 hours before the visit we were coming so they could arrange to be there and arrange for care workers to be available to talk with us about the service.

This was the first inspection of New Hope Care Coventry at this location.

The service had 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 not available on the day of the inspection. The inspection was supported by the deputy manager and the provider’s nominated individual who was present for most of the office visit.

Prior to this inspection we had received concerns from care staff and commissioners of the service about late and missed calls, staff recruitment practices and staff not being paid. We were able to look at these concerns during our inspection.

We found the service provided was not consistently safe. Not all care workers understood how to recognise abuse or how to report safeguarding concerns. Risks associated with people’s care had not always been identified and there was no information for staff to follow about how some identified risks were to be managed safely.

Documentation to show staff had been recruited safely was not available for all care workers employed by the service. Where agency staff had been used to cover care worker absences there was no evidence to show these staff had been properly checked and trained before providing care to people.

Care workers told us they completed training to provide the care people required but some said the training they received had been very basic. Most care workers we spoke with had little understanding about the training they had completed and were unable to tell us how they put some of their training into practice.

The deputy manager had an understanding of the principles of the Mental Capacity Act (MCA) and their responsibility under the Act. Most care workers we spoke with had no understanding of the Act and how this affected their practice. However, people told us care workers asked for their consent before providing care and respected any decisions they made.

Managers and care workers told us there was sufficient staff to provide all the scheduled calls to people. However, we were told there was no capacity to cover staff sickness and staff work rotas showed some care workers worked very long hours without any time off.

People told us they had regular care workers who stayed long enough to provide all the care and support they required and had time to sit and talk to them. Most people said the times care workers arrived had improved recently and they now arrived around the time expected. Although some people told us they had experienced late calls.

Most people felt involved in their care and care plans provided guidance for staff about how people liked their care delivered. Care workers knew how people liked to receive their care and had time to read their care plans. People told us care workers were kind and respected their privacy and dignity.

Care workers received support and supervision to carry out their roles which included regular observations of their practice.

People knew how to complain and information about making a complaint was available for people. Care workers said they could raise any concerns with the office staff, knowing they would be listened to and acted on.

The provider had processes to monitor the