We carried out this announced inspection between the 14 June and 29 June 2018. The registered provider was given short notice of our intention to inspect the service. This is in accordance with the Care Quality Commission’s [CQC] current procedures for inspecting domiciliary care services.

Newline Care Services is a community based domiciliary care service which provides personal care and support to adults living in their own homes. The service is operated from offices in the Idle area of Bradford and supports people in both Bradford and Leeds. At the time of the inspection 54 people were using the service.

Our last inspection took place in January 2017and at that time we found the service was not meeting four of the regulations we looked at. These related to Safe care and treatment, Need for consent, Safeguarding service users from abuse and improper treatment and Good governance.

On this inspection we found the registered provider had made improvements in all areas of service delivery and no breaches of regulations were identified.

People told us they felt safe having their care and support provided by Newline Care Services. We found staff had received training in safeguarding vulnerable people and were aware of the correct action to take if they witnessed or suspected any abuse. Staff were aware of the whistleblowing (reporting poor practice) policy and told us they were certain any concerns they raised would be taken seriously by the registered manager.

The care records we looked at showed people’s needs had been assessed prior to any service commencing. They were detailed and showed what support the person required and how the service planned to provide it. The assessment process ensured staff could meet people’s needs and the information gathered was used to develop support plans and risk assessments.

We found support plans were person centred and contained detailed information that guided staff on the level of support people needed to meet their health and social care needs. Care records were reviewed regularly to ensure they reflected people’s changing needs and detailed risk assessment were in place.

People’s nutritional needs were met if this was part of their agreed care package and people were encouraged to eat a varied and balanced diet. People told us staff treated them with respect and promoted their independence and right to privacy.

There were enough staff to meet people’s assessed needs. People received continuity of care provided by a small staff team who knew them well. Safe recruitment practices were followed to reduce the risk of people being unsuitable to work in the caring profession being employed. Staff were trained and supported to have the skills and knowledge to meet people’s needs. Staff enjoyed their role and felt valued by the registered manager.

The service had an infection control policy which gave staff guidance on preventing, detecting and controlling the spread of infection. Staff had received training on infection prevention and control.

The registered manager demonstrated a good understanding of their responsibilities under the Mental Capacity Act 2005 (MCA) and staff demonstrated good knowledge of the people they supported and their capacity to make decisions. The registered manager and staff were aware of the process to follow should a person lack the capacity to consent to their care.

We found the registered manager and all the staff we spoke with were able to tell us about the people who used the service. They knew their likes and dislikes and things that were important to them.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. People told us they felt able to raise any concerns with the registered manager and felt these would be listened to and responded to effectively and in a timely manner.

The registered manager and staff were aware of the need to protect people’s confident

We inspected this service on 31 January 2017 and it was announced

This was the first inspection of Newline Care Services Ltd since it registered with the Care Quality Commission (CQC) in 2014.

At the time of our inspection Newline Care Services Ltd provided personal care to 50 people in their own homes mainly in areas of Bradford but some within the Leeds area.

There was a registered manager 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 2008 and associated Regulations about how the service is run.

The registered manager was supported by a care manager, a HR manager and an office manager. 25 care staff were employed at the time of the inspection including two going through the induction process.

We found medicines were not managed safely and safeguarding incidents were not always recognised or reported appropriately.

There were enough staff to meet the needs of people who used the service. Staff arrived on time and stayed for the planned duration of the visit. There were no reports of missed calls. Systems were in place to alert managers if staff did not arrive at a person’s house at the planned time.

We found staff lacked understanding about the lawful processes for assessing mental capacity and determining best interest decisions and these processes had not always been followed.

We found staff to have received an appropriate induction, supervision, appraisal and training which allowed them to fulfil their roles.

People who used the service were complimentary of the care and support they received.

Staff were pro-active in making sure people’s healthcare needs were met and were encouraged to call healthcare professionals for advice or attention where they had concerns about a person using the service.

We found a lack of consistency in care records. Some were comprehensive whilst others lacked the detail staff would need to provide appropriate care. Plans were in place to introduce more person centred care documentation.

People who used the service told us the service responded quickly to any issues raised.

Systems to monitor the quality and safety of the service were in place but were not operated effectively.

We found four 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 the report.