We carried out the inspection on 23 February 2017. The registered manager was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

The service is a domiciliary care agency that provides personal care to people in their own homes. At the time of our inspection10 people used the service.

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.

People told us they felt safe. Risks associated with people’s care were assessed and managed to protect people from harm. People could be assured that staff would arrive to provide the care that they needed.

People were supported by staff who understood their responsibilities to keep them safe and report any concerns they may have. There was a recruitment policy in place which the provider followed. We found that all the required pre-employment checks were being carried out before staff commenced work at the service.

People received their medicines as required. Medicines were administered safely by staff who were appropriately trained and competent to do so. People’s health needs were met and when necessary, outside health professionals were contacted for support. They were supported to have enough to eat and drink.

Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported. Their competence to do their role was regularly assessed.

People made decisions about the care and the support they received. People’s consent was sought and respected. The provider understood their responsibility to ensure people were supported in line with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People’s independence was promoted and people were encouraged to make choices. Staff treated people with kindness and compassion. Dignity and respect for people was promoted.

The care needs of people had been assessed. Staff had a clear understanding of their role and how to support people who used the service. People contributed to the planning and reviewing of their care.

People were supported to pursue their interests and access the community. Consideration into people’s cultural and religious needs had taken.

Complaints were addressed in line with the provider’s policy. People were encouraged to give feedback about the service they received.

People and staff felt that the registered manager and provider were approachable and action would be taken to address any concerns they may have.

Systems were in place to measure the quality and care delivered so that required improvements could be identified and addressed.

We carried out the inspection on 16 March 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

The service is a domiciliary care agency that provides personal care to people in their own homes. At the time of our inspection 19 people used the service.

The service was last inspected 2 February 2015 and was found to require improvement in all domains except caring which was rated as good. It was also found to be in breach of two regulations.. The registered person had not ensured the safe and effective operation of recruitment procedures and had not protected people against the risk of inappropriate or unsafe care. We checked to see if improvements had been made to meet the requirements of the Health and Social Care Act 2008. We found that sufficient improvements had been made in both areas.

The service did not have 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. A new manager had commenced working for the service nine weeks prior to our inspection. They informed us that they intended to apply to CQC to become the registered manager.

People told us that they felt safe in their own homes. The manager had assessed the risks associated with providing care in the home environment. Staff understood their responsibility to make checks within people’s home and of equipment to keep themselves and people safe.

Staff understood how to keep people safe and report concerns if needed. The manager had ensured that all staff had undergone relevant employment checks.

People did not receive their medicines as required and medicines were not managed safely.

Not all staff had received training to meet the needs of the people who used the service. The manager was in the process of ensuring that all staff received appropriate training and support to be able to fulfil their role.

Some people had the capacity to make decisions about their care and the support they received. These people were involved and their opinions sought and respected. Where people required support to make decisions, the service did not follow the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards DoLS), best interest decisions had not been made in line with the Act.

People were supported to maintain their health and wellbeing. People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have sufficient to eat and drink.

Staff respected people’s homes. People’s independence was promoted and choice making encouraged. Staff adapted their communication style so that people were supported to understand.

The manager had assessed the care needs of people using the service. Staff had a clear understanding of their role and how to support people who used the service as individuals.

Staff knew people well and treated them with kindness and compassion. People received a consistent level of support.

Staff felt supported by the manager. They were clear on their role and the expectations on them People who used the service and staff felt they could talk to the manager and had confidence that they would address issues if required. People told us that they knew how to make a complaint if they needed to. Relatives found the manager to be approachable.

The manager had implemented systems to monitor the provision of service. The provider did not have effective systems for gathering information about the service, identifying areas of concern and to drive improvement.

This inspection took place on 2 February 215 and was unannounced. New Hope Care provides personal care to people in their own homes. At the time of the inspection, 17 people were using the service. The service provides care to people with a range of conditions including dementia, physical and learning disabilities.

A registered manager was in post. 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.

There was a risk that people could receive inappropriate or unsafe care and support as risks associated with people’s health conditions had not always been assessed.

Safe recruitment procedures were not always followed. This meant that there was a risk that unsuitable staff would be employed at the agency.

Staff received an induction when they commenced work and on-going training and support. Staff were knowledgeable about people’s needs and preferences. However some staff recognised that they required more in depth training about certain health conditions in order to meet people’s specific care needs .

People told us that they were happy with the care and support they received, that they had been involved in the development of their plans of care and that care was provided at the agreed times.

People said they received their medicines at the right time.

People told us that they felt safe with staff, who had received training on how to protect people who used the service from abuse or harm. Staff demonstrated that they were aware of their role and responsibilities in keeping people as safe as possible.

People who used the service and relatives told us they found staff to be caring and respectful. They told us that they received care and support in the way they preferred, however details of people’s preferences and daily routines was not always recorded in their plan of care.

People told us that staff obtained their consent before care and support was provided. However, staff were not aware of the principles of the Mental Capacity Act 2005 to enable people’s best interests to be met, should the need for this arise.

People told us that staff supported them so that they were provided with meals and drinks of their choice.

The registered manager understood their responsibilities and demonstrated a commitment to providing quality care. Further development of the provider’s quality assurance systems were needed to further ensure people’s safety and that their needs were being met.

The registered manager gave staff opportunities to share their views about how the service was run. People were confident to raise any issues, concerns or to make complaint.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond to a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 . You can see what action we told the provider to take at the back of the full version of this report.